Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.
BMJ Open. 2024 Aug 25;14(8):e086683. doi: 10.1136/bmjopen-2024-086683.
To develop and internally validate a prognostic model to predict chronic pain after a new episode of acute or subacute non-specific idiopathic, non-traumatic neck pain in patients presenting to physiotherapy primary care, emphasising modifiable biomedical, psychological and social factors.
A prospective cohort study with a 6-month follow-up between January 2020 and March 2023.
30 physiotherapy primary care practices.
Patients with a new presentation of non-specific idiopathic, non-traumatic neck pain, with a duration lasting no longer than 12 weeks from onset.
Candidate prognostic variables collected from participants included age and sex, neck pain symptoms, work-related factors, general factors, psychological and behavioural factors and the remaining factors: therapeutic relation and healthcare provider attitude.
Pain intensity at 6 weeks, 3 months and 6 months on a Numeric Pain Rating Scale (NPRS) after inclusion. An NPRS score of ≥3 at each time point was used to define chronic neck pain.
62 (10%) of the 603 participants developed chronic neck pain. The prognostic factors in the final model were sex, pain intensity, reported pain in different body regions, headache since and before the neck pain, posture during work, employment status, illness beliefs about pain identity and recovery, treatment beliefs, distress and self-efficacy. The model demonstrated an optimism-corrected area under the curve of 0.83 and a corrected R of 0.24. Calibration was deemed acceptable to good, as indicated by the calibration curve. The Hosmer-Lemeshow test yielded a p-value of 0.7167, indicating a good model fit.
This model has the potential to obtain a valid prognosis for developing chronic pain after a new episode of acute and subacute non-specific idiopathic, non-traumatic neck pain. It includes mostly potentially modifiable factors for physiotherapy practice. External validation of this model is recommended.
开发并内部验证一个预测模型，以预测在理疗初级保健中出现新的急性或亚急性非特异性特发性、非创伤性颈痛发作后慢性疼痛的发生，重点强调可改变的生物医学、心理和社会因素。
一项前瞻性队列研究，在 2020 年 1 月至 2023 年 3 月期间进行了 6 个月的随访。
30 家理疗初级保健诊所。
出现新的非特异性特发性、非创伤性颈痛发作的患者，起病后疼痛持续时间不超过 12 周。
从参与者收集的候选预后变量包括年龄和性别、颈痛症状、与工作相关的因素、一般因素、心理和行为因素以及其余因素：治疗关系和医疗保健提供者的态度。
纳入后第 6 周、第 3 个月和第 6 个月的数字疼痛评分量表（NPRS）上的疼痛强度。每个时间点的 NPRS 评分≥3 用于定义慢性颈痛。
在 603 名参与者中，有 62 名（10%）发展为慢性颈痛。最终模型中的预后因素包括性别、疼痛强度、报告的不同身体区域疼痛、颈痛前后的头痛、工作时的姿势、就业状况、对疼痛身份和恢复的疾病信念、治疗信念、痛苦和自我效能。该模型的校正曲线下面积为 0.83，校正 R 为 0.24，显示出乐观校正后的良好预测能力。校准被认为是可接受的，良好的，正如校准曲线所示。Hosmer-Lemeshow 检验的 p 值为 0.7167，表明模型拟合良好。
该模型有可能对理疗初级保健中出现新的急性和亚急性非特异性特发性、非创伤性颈痛后慢性疼痛的发生进行有效预测。它包括大多数对理疗实践有潜在可改变的因素。建议对该模型进行外部验证。
