Treatment success in neck pain: The added predictive value of psychosocial variables in addition to clinical variables

Author:

Groeneweg Ruud1234,Haanstra Tsjitske5,Bolman Catherine A.W.4,Oostendorp Rob A.B.26,van Tulder Maurits W.1,Ostelo Raymond W.J.G.15

Affiliation:

1. Department of Health Sciences & EMGO Institute for Health and Care Research , Faculty of Earth & Life Sciences , VU University , Amsterdam , The Netherlands

2. Radboud University Nijmegen Medical Centre , Scientific Institute for Quality of Health Care , Nijmegen , The Netherlands

3. Avans+ , University for Applied Sciences , Breda , The Netherlands

4. Faculty of Psychology & Educational Sciences , Open University of the Netherlands , PO Box 2960 , Heerlen , 6401 DL , The Netherlands

5. Department of Epidemiology and Biostatistics AND the EMGO Institute for Health and Care Research , VU University Medical Centre , Amsterdam , The Netherlands

6. Free University of Brussels , Faculty of Medicine and Pharmacology , Department of Manual Therapy , Brussels , Belgium

Abstract

Abstract Background and aims Identification of psychosocial variables may influence treatment outcome. The objective of this study was to prospectively examine whether psychosocial variables, in addition to clinical variables (pain, functioning, general health, previous neck pain, comorbidity), are predictive factors for treatment outcome (i.e. global perceived effect, functioning and pain) in patients with sub-acute and chronic non-specific neck pain undergoing physical therapy or manual therapy. Psychosocial factors included treatment outcome expectancy and treatment credibility, health locus of control, and fear avoidance beliefs. Methods This study reports a secondary analysis of a primary care-based pragmatic randomized controlled trial. Potential predictors were measured at baseline and outcomes, in 181 patients, at 7 weeks and 26 weeks. Results Hierarchical logistic regression models showed that treatment outcome expectancy predicted outcome Conclusions Based on the results of this study we conclude that outcome expectancy, in patients with non-specific sub-acute and chronic neck pain, has additional predictive value for treatment success above and beyond clinical and demographic variables. Implications Psychological processes, health perceptions and how these factors relate to clinical variables may be important for treatment decision making regarding therapeutic options for individual patients.

Funder

Stichting Gezondheidszorg Spaarneland (Healthcare Foundation Spaarneland), The Netherlands

Publisher

Walter de Gruyter GmbH

Subject

Anesthesiology and Pain Medicine,Neurology (clinical)

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