title: The contribution of previous episodes of pain, pain intensity, physical impairment, and pain-related fear to disability in patients with chronic mechanical neck pain.
abstract: OBJECTIVE
  The influence of physical and psychosocial variables on self-rated disability in patients with chronic mechanical neck pain has not been fully determined. This study examined the relationship of pain, physical impairment, and pain-related fear to disability in individuals with chronic mechanical neck pain.
  
  
  METHODS
  A cross-sectional study was conducted. Ninety-seven (n = 97) subjects (28 men, 69 women; mean age, 39.3 yrs) with chronic mechanical neck pain were prospectively recruited. Demographic information, duration of pain symptoms, pain intensity, pain-related fear, and cervical range of motion were collected on all subjects. Self-reported disability was measured with the Neck Disability Index. Correlation and regression analyses were performed to determine the association among the variables and to determine the proportions of explained variance in disability.
  
  
  RESULTS
  Significant positive correlations existed between disability and previous history of neck pain (r = 0.45; P < 0.001), disability and pain intensity (r = 0.32, P = 0.01), and disability and kinesiophobia (r = 0.23, P = 0.02). In addition, a significant negative correlation existed between disability and cervical extension range of motion (r = -0.18, P = 0.04). Stepwise regression analyses revealed that previous neck pain episodes, intensity of neck pain, kinesiophobia, and cervical extension range of motion were significant predictors of disability (r = 0.400; r adjusted = 0.372; F = 14.64; P < 0.001).
  
  
  CONCLUSIONS
  This study found that previous episodes of neck pain, pain intensity, pain-related fear, and cervical extension range of motion explained 37.2% of the variability of self-report disability. Future longitudinal studies will help to determine the clinical implications of these findings.
authors.affiliation: Department of Physical Therapy, Universidad of Almería, Almería, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Saavedra-Hernández
authors.forename: Adelaida M
authors.initials: AM
authors.lastname: Castro-Sánchez
authors.forename: Antonio I
authors.initials: AI
authors.lastname: Cuesta-Vargas
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Cleland
authors.forename: César
authors.initials: C
authors.lastname: Fernández-de-las-Peñas
authors.forename: Manuel
authors.initials: M
authors.lastname: Arroyo-Morales
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000503:physiopathology; D019547:Neck Pain / Q000503:physiopathology / Q000534:rehabilitation*; D016059:Range of Motion, Articular; D055815:Young Adult