title: Subjective and clinical assessment criteria suggestive for five clinical patterns discernible in nonspecific neck pain patients. A Delphi-survey of clinical experts.
abstract: BACKGROUND
  Nonspecific neck pain patients form a heterogeneous group with different musculoskeletal impairments. Classifying nonspecific neck pain patients into subgroups based on clinical characteristics might lead to more comprehensive diagnoses and can guide effective management.
  
  
  OBJECTIVE
  To establish consensus among a group of experts regarding the clinical criteria suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central' and 'sensorimotor control' dysfunction patterns distinguishable in patients with nonspecific neck pain.
  
  
  METHODS
  Delphi study.
  
  
  METHODS
  A focus group with 10 academic experts was organized to elaborate on the different dysfunction patterns discernible in neck pain patients. Consecutively, a 3-round online Delphi-survey was designed to obtain consensual symptoms and physical examination findings for the 5 distinct dysfunction patterns resulting from the focus group.
  
  
  RESULTS
  A total of 21 musculoskeletal physical therapists from Belgium and the Netherlands experienced in assessing and treating neck pain patients completed the 3-round Delphi-survey. Respectively, 33 (response rate, 100.0%), 27 (81.8%) and 21 (63.6%) respondents replied to rounds 1, 2 and 3. Eighteen 'articular', 16 'myofascial', 20 'neural', 18 'central' and 10 'sensorimotor control' clinical indicators reached a predefined ≥80% consensus level.
  
  
  CONCLUSIONS
  These indicators suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central', and 'sensorimotor control' dysfunction patterns may help clinicians to assess and diagnose patients with nonspecific neck pain. Future validity testing is needed to determine how these criteria may help to improve the outcome of physical therapy interventions in nonspecific neck pain patients.
authors: Department of Rehabilitation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 (3B3), 9000 Ghent, Belgium. Electronic address: Vincent.Dewitte@UGent.be.
authors: Vincent
authors: V
authors: Dewitte
authors: Department of Family Medicine and Primary Health Care, Ghent University, De Pintelaan 185 (6K3), 9000 Ghent, Belgium. Electronic address: Wim.Peersman@UGent.be.
authors: Wim
authors: W
authors: Peersman
authors: Department of Rehabilitation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 (3B3), 9000 Ghent, Belgium. Electronic address: Lieven.Danneels@UGent.be.
authors: Lieven
authors: L
authors: Danneels
authors: Centre for Musculoskeletal and Neurological Rehabilitation, Ghent University Hospital, De Pintelaan 185 (K7), 9000 Ghent, Belgium. Electronic address: Katie.bouche@uzgent.be.
authors: Katie
authors: K
authors: Bouche
authors: Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium. Electronic address: Arne.Roets@UGent.be.
authors: Arne
authors: A
authors: Roets
authors: Department of Rehabilitation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 (3B3), 9000 Ghent, Belgium. Electronic address: Barbara.Cagnie@UGent.be.
authors: Barbara
authors: B
authors: Cagnie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D003697:Delphi Technique; D019937:Diagnostic Techniques and Procedures / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000503:physiopathology*; D019547:Neck Pain / Q000145:classification* / Q000175:diagnosis*; D009426:Netherlands; D010808:Physical Examination / Q000592:standards*; D059825:Physical Therapists; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires
keywords: Cervical spine; Clinical patterns; Clinical reasoning; Consensus