Predictors of outcome in neck pain patients undergoing chiropractic care comparison of acute and chronic patients 英文参考文献.docVIP

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Predictors of outcome in neck pain patients undergoing chiropractic care comparison of acute and chronic patients 英文参考文献.doc

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Predictors of outcome in neck pain patients undergoing chiropractic care comparison of acute and chronic patients 英文参考文献

Petersonetal.ChiropracticManualTherapies2012,20:27 /content/20/1/27 CHIROPRACTIC MANUAL THERAPIES RESEARCH OpenAccess Predictorsofoutcomeinneckpainpatients undergoingchiropracticcare:comparisonof acuteandchronicpatients CynthiaPeterson1*,JenniferBolton2andBKimHumphreys1 Abstract Background:Neckpainisacommoncomplaintinpatientspresentingforchiropractictreatment.Thefewstudies onpredictorsforimprovementinpatientswhileundergoingtreatmentidentifydurationofsymptoms,neck stiffnessandnumberofpreviousepisodesasthestrongpredictorvariables.Thepurposeofthisstudyisto continuetheresearchforpredictorsofapositiveoutcomeinneckpainpatientsundergoingchiropractictreatment. Methods:Acute(4weeks)(n=274)andchronic(3months)(n=255)neckpainpatientswithnochiropractic ormanualtherapyintheprior3monthswereincluded.Patientscompletedthenumericalpainratingscale(NRS) andBournemouthquestionnaire(BQ)atbaselinepriortotreatment.At1week,1monthand3monthsafterstart oftreatmenttheNRSandBQwerecompletedalongwiththePatientGlobalImpressionofChange(PGIC)scale. Demographicinformationwasprovidedbytheclinician.Improvementateachofthefollowuppointswas categorizedusingthePGIC.Multivariateregressionanalysesweredonetodeterminesignificantindependent predictorsofimprovement. Results:Baselinemeanneckpainandtotaldisabilityscoresweresignificantly(p0.001andp0.008respectively) higherinacutepatients.Bothgroupsreportedsignificantimprovementatalldatacollectiontimepoints,butwas significantlylargerforacutepatients.ThePGICscoreat1week(OR=3.35,95%CI=1.13-9.92)andthebaselineto 1monthBQtotalchangescore(OR=1.07,95%CI=1.03-1.11)wereidentifiedasindependentpredictorsof improvementat3monthsforacutepatients.ChronicpatientswhoreportedimprovementonthePGICat1month weremorelikelytobeimprovedat3months(OR=6.04,95%CI=2.76-13.69).Thepresenceofcervical radiculopathyordizzinesswasnotpredictiveofanegativeoutcomeinthesepatients. Conclusions:Themostconsistentpredictorofclinicallyrelevantimprovementatboth1and3monthsafterthe startofchiropractictreatmentfo