Identifying prognostic factors predicting outcome in patients with chronic neck pain after multimodal treatment: A retrospective study.
OBJECTIVE
This study was conducted to identify possible prognostic factors to predict drop-out and favorable outcome in patients following a multimodal treatment program at an outpatient rehabilitation clinic.


METHODS
A retrospective cohort study was conducted on 437 patients with chronic neck pain involved in an exercise-based rehabilitation program of an outpatient rehabilitation center between January 2008 and November 2011. Prognostic factors were analyzed through a univariate and a multivariate logistic regression analysis.


RESULTS
Multivariate logistic regression revealed that a higher age (OR=0.960), presence of headache (OR=0.436) or low back pain (OR=0.525), and having low levels of depression (OR=1.044) increase the odds to complete the multimodal treatment program. A high NDI-score (OR=0.945), a high NRS-score for pain in the upper extremities (OR=0.862), a low NRS score for pain in the neck (OR=1.372), and a trauma in the patient's history (OR=0.411) decrease the odds of having a favorable outcome after the given treatment program.


CONCLUSIONS
It is important to assess these prognostic factors as they may help therapists to identify patients with a good prognosis or patients at risk. For those at risk, this would allow the treatment approach to be redirected to address their specific needs.
Ghent University, Department of Rehabilitation Sciences and Physiotherapy, De Pintelaan 185 3B3, 9000 Ghent, Belgium. Electronic address: Robby.DePauw@ugent.be.
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De Pauw
Ghent University, Department of Rehabilitation Sciences and Physiotherapy, De Pintelaan 185 3B3, 9000 Ghent, Belgium. Electronic address: Jeroen.Kregel@Ugent.be.
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Kregel
Ghent University, Department of Rehabilitation Sciences and Physiotherapy, De Pintelaan 185 3B3, 9000 Ghent, Belgium. Electronic address: Cedric.DeBlaiser@UGent.be.
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De Blaiser
AZ St-Dimpna, Department of Physical and Rehabilitation Medicine, J.B. Stessensstraat 2, 2440 Geel, Belgium. Electronic address: dr.jens.vanakeleyen@azstdimpna.be.
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Van Akeleyen
AZ St-Dimpna, Department of Physical and Rehabilitation Medicine, J.B. Stessensstraat 2, 2440 Geel, Belgium. Electronic address: dr.tine.logghe@azstdimpna.be.
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Logghe
Ghent University, Department of Rehabilitation Sciences and Physiotherapy, De Pintelaan 185 3B3, 9000 Ghent, Belgium. Electronic address: Lieven.Danneels@Ugent.be.
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Danneels
Ghent University, Department of Rehabilitation Sciences and Physiotherapy, De Pintelaan 185 3B3, 9000 Ghent, Belgium. Electronic address: Barbara.Cagnie@Ugent.be.
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Cagnie
D000328:Adult; D002908:Chronic Disease / Q000534:rehabilitation; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000379:methods; D003863:Depression / Q000209:etiology; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D019547:Neck Pain / Q000150:complications / Q000534:rehabilitation*; D010147:Pain Measurement; D026761:Physical Therapy Specialty / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
Logistic regression; Neck pain; Prognosis; Treatment