OBJECTIVE: To conduct a systematic review and meta-analysis on the prognosis of acute idiopathic neck pain and disability. DATA SOURCES: EMBASE, CINAHL, Medline, AMED, PEDro, and CENTRAL were searched from inception to July 2009, limited to human studies. Reference lists of relevant systematic reviews were searched by hand. Search terms included: neck pain, prognosis, inception, cohort, longitudinal, observational, or prospective study and randomized controlled trial. STUDY SELECTION: Eligible studies were longitudinal cohort studies and randomized controlled trials with a no treatment or minimal treatment arm that recruited an inception cohort of acute idiopathic neck pain and reported pain or disability outcomes. Eligibility was determined by 2 authors independently. Seven of 20,085 references were included. DATA EXTRACTION: Pain and disability data were extracted independently by 2 authors. Risk of bias was assessed independently by 2 authors. DATA SYNTHESIS: Statistical pooling showed a weighted mean pain score (0-100) of 64 (95% confidence interval [CI], 61-67) at onset and 35 (95% CI, 32-38) at 6.5 weeks. At 12 months, neck pain severity remained high at 42 (95% CI, 39-45). Disability reduced from a pooled weighted mean score (0-100) at onset of 30 (95% CI, 28-32) to 17 (95% CI, 15-19) by 6.5 weeks, without further improvement at 12 months. Studies varied in length of follow-up, design, and sample size. CONCLUSIONS: This review provides Level I evidence that the prognosis of acute idiopathic neck pain is worse than currently recognized. This evidence can guide primary care clinicians when providing prognostic information to patients. Further research to identify prognostic factors and long-term outcomes from inception cohorts would be valuable.
AD - Discipline of Physiotherapy, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia. Julia.hush@sydney.edu.au AN - 21458776 BT - Archives of Physical Medicine and Rehabilitation ET - 2011/04/05 LA - eng M1 - 5 N1 - Hush, Julia MLin, C ChristineMichaleff, Zoe AVerhagen, ArianneRefshauge, Kathryn MMeta-AnalysisResearch Support, Non-U.S. Gov'tReviewUnited StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2011 May;92(5):824-9. Epub 2011 Apr 1. N2 -OBJECTIVE: To conduct a systematic review and meta-analysis on the prognosis of acute idiopathic neck pain and disability. DATA SOURCES: EMBASE, CINAHL, Medline, AMED, PEDro, and CENTRAL were searched from inception to July 2009, limited to human studies. Reference lists of relevant systematic reviews were searched by hand. Search terms included: neck pain, prognosis, inception, cohort, longitudinal, observational, or prospective study and randomized controlled trial. STUDY SELECTION: Eligible studies were longitudinal cohort studies and randomized controlled trials with a no treatment or minimal treatment arm that recruited an inception cohort of acute idiopathic neck pain and reported pain or disability outcomes. Eligibility was determined by 2 authors independently. Seven of 20,085 references were included. DATA EXTRACTION: Pain and disability data were extracted independently by 2 authors. Risk of bias was assessed independently by 2 authors. DATA SYNTHESIS: Statistical pooling showed a weighted mean pain score (0-100) of 64 (95% confidence interval [CI], 61-67) at onset and 35 (95% CI, 32-38) at 6.5 weeks. At 12 months, neck pain severity remained high at 42 (95% CI, 39-45). Disability reduced from a pooled weighted mean score (0-100) at onset of 30 (95% CI, 28-32) to 17 (95% CI, 15-19) by 6.5 weeks, without further improvement at 12 months. Studies varied in length of follow-up, design, and sample size. CONCLUSIONS: This review provides Level I evidence that the prognosis of acute idiopathic neck pain is worse than currently recognized. This evidence can guide primary care clinicians when providing prognostic information to patients. Further research to identify prognostic factors and long-term outcomes from inception cohorts would be valuable.
PY - 2011 SN - 1532-821X (Electronic)0003-9993 (Linking) SP - 824 EP - 9 T2 - Archives of Physical Medicine and Rehabilitation TI - Prognosis of acute idiopathic neck pain is poor: a systematic review and meta-analysis VL - 92 ER -