title: Prognostic factors for recurrences in neck pain patients up to 1 year after chiropractic care.
abstract: OBJECTIVE
  Information about recurrence and prognostic factors is important for patients and practitioners to set realistic expectations about the chances of full recovery and to reduce patient anxiety and uncertainty. Therefore, the purpose of this study was to assess recurrence and prognostic factors for neck pain in a chiropractic patient population at 1 year from the start of the current episode.
  
  
  METHODS
  Within a prospective cohort study, 642 neck pain patients were recruited by chiropractors in Switzerland. After a course of chiropractic therapy, patients were followed up for 1 year regarding recurrence of neck pain. A logistic regression analysis was used to assess prognostic factors for recurrent neck pain. The independent variables age, pain medication usage, sex, work status, duration of complaint, previous episodes of neck pain and trauma onset, numerical rating scale, and Bournemouth questionnaire for neck pain were analyzed. Prognostic factors that have been identified in previous studies to influence recovery of neck pain are psychologic distress, poor general health at baseline, and a previous history of pain elsewhere.
  
  
  RESULTS
  Five hundred forty five patients (341 females), with a mean age of 42.1 years (SD, 13.1) completed the 1-year follow-up period. Fifty-four participants (11%) were identified as "recurrent." Prognostic factors associated with recurrent neck pain were previous episodes of neck pain and increasing age.
  
  
  CONCLUSIONS
  The results of this study suggest that recurrence of neck pain within 1 year after chiropractic intervention in Swiss chiropractic patients presenting from varied onsets is low. This study found preliminary findings that older age and a previous episode of neck may be useful predictors of neck pain recurrence within 1 year.
authors.affiliation: PhD Student, CAPHRI School of Public Health and Primary Care, Department of Epidemiology, Maastricht University, Maastricht, The Netherlands; Researcher, Department of Chiropractic Medicine, University of Zurich and University Hospital Balgrist, Zurich, Switzerland; Researcher, Department of Physiotherapy, University Hospital Balgrist, Zurich, Switzerland. Electronic address: anke.langenfeld@maastrichtuniversity.nl.
authors.forename: Anke
authors.initials: A
authors.lastname: Langenfeld
authors.affiliation: Professor, Department of Chiropractic Medicine, University of Zurich and University Hospital Balgrist, Zurich, Switzerland.
authors.forename: B Kim
authors.initials: BK
authors.lastname: Humphreys
authors.affiliation: Head of Physiotherapy Research, Department of Physiotherapy, University Hospital Balgrist, Zurich, Switzerland; Lecturer, Department of Chiropractic Medicine, University of Zurich and University Hospital Balgrist, Zurich, Switzerland; Researcher, Physiotherapy Occupational Therapy Research, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Jaap
authors.initials: J
authors.lastname: Swanenburg
authors.affiliation: Professor, Department of Chiropractic Medicine, University of Zurich and University Hospital Balgrist, Zurich, Switzerland.
authors.forename: Cynthia K
authors.initials: CK
authors.lastname: Peterson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D026882:Manipulation, Chiropractic / Q000379:methods*; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis* / Q000534:rehabilitation*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D013557:Switzerland; D013997:Time Factors; D016896:Treatment Outcome
keywords: Chiropractic; Forecasting; Neck Pain; Recurrence