title: Baseline characteristics of patients with nerve-related neck and arm pain predict the likely response to neural tissue management.
abstract: METHODS
  Planned secondary analysis of a randomized controlled trial comparing neural tissue management (NTM) to advice to remain active.
  
  
  OBJECTIVE
  To develop a model that predicts the likelihood of patient-reported improvement following NTM.
  
  
  BACKGROUND
  Matching patients to an intervention they are likely to benefit from potentially improves outcomes. However, baseline characteristics that predict patients' responses to NTM are unknown.
  
  
  METHODS
  Data came from 60 consecutive adults who had nontraumatic, nerve-related neck and unilateral arm pain for at least 4 weeks. Participants were assigned to a group that received NTM (n = 40), which involved brief education, manual therapy, and nerve gliding exercises for 4 treatments over 2 weeks, or to a group that was given advice to remain active (n = 20), which involved instruction to continue their usual activities. The participants' global rating of change at a 3- to 4-week follow-up defined improvement. Penalized regression of NTM data identified the best prediction model. A medical nomogram was created for prediction model scoring. Post hoc analysis determined whether the model predicted a specific response to NTM.
  
  
  RESULTS
  Absence of neuropathic pain qualities, older age, and smaller deficits in median nerve neurodynamic test range of motion predicted improvement. Prediction model cutoffs increased the likelihood of improvement from 53% to 90% (95% confidence interval: 56%, 98%) or decreased the likelihood of improvement to 9% (95% confidence interval: 1%, 42%). The model did not predict the outcomes of the advice to remain active group.
  
  
  CONCLUSIONS
  Baseline characteristics of patients with nerve-related neck and arm pain predicted the likelihood of improvement with NTM. Model performance needs to be validated in a new sample using different comparison interventions and longer follow-up. Australian New Zealand Clinical Trials Registry (ACTRN 12610000446066).
  
  
  METHODS
  Prognosis, level 2b-.
authors: Division of Physiotherapy and National Health and Medical Research Council Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia. robertjnee@gmail.com
authors: Robert J
authors: RJ
authors: Nee
authors: Bill
authors: B
authors: Vicenzino
authors: Gwendolen A
authors: GA
authors: Jull
authors: Joshua A
authors: JA
authors: Cleland
authors: Michel W
authors: MW
authors: Coppieters
mesh_terms: D000328:Adult; D001132:Arm / Q000294:innervation; D003661:Decision Support Techniques; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations; D019547:Neck Pain / Q000628:therapy*; D009437:Neuralgia / Q000628:therapy*; D011237:Predictive Value of Tests