Neck pain patterns and subgrouping based on weekly SMS-derived trajectories.

Autor: Irgens P; Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, P.O. Box 1089, Blindern, 0317, Oslo, Norway. p.m.irgens@medisin.uio.no., Kongsted A; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.; Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark., Myhrvold BL; Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, P.O. Box 1089, Blindern, 0317, Oslo, Norway., Waagan K; Department for Data Capture and Collections Management, University Center for Information Technology, University of Oslo, Oslo, Norway., Engebretsen KB; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway., Natvig B; Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway., Vøllestad NK; Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, P.O. Box 1089, Blindern, 0317, Oslo, Norway., Robinson HS; Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, P.O. Box 1089, Blindern, 0317, Oslo, Norway.
Jazyk: angličtina
Zdroj: BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2020 Oct 14; Vol. 21 (1), pp. 678. Date of Electronic Publication: 2020 Oct 14.
DOI: 10.1186/s12891-020-03660-0
Abstrakt: Background: Neck and low back pain represent dynamic conditions that change over time, often with an initial improvement after the onset of a new episode, followed by flare-ups or variations in intensity. Pain trajectories were previously defined based on longitudinal studies of temporal patterns and pain intensity of individuals with low back pain. In this study, we aimed to 1) investigate if the defined patterns and subgroups for low back pain were applicable to neck pain patients in chiropractic practice, 2) explore the robustness of the defined patterns, and 3) investigate if patients within the various patterns differ concerning characteristics and clinical findings.
Methods: Prospective cohort study including 1208 neck pain patients from chiropractic practice. Patients responded to weekly SMS-questions about pain intensity and frequency over 43 weeks. We categorized individual responses into four main patterns based on number of days with pain and variations in pain intensity, and subdivided each into four subgroups based on pain intensity, resulting in 16 trajectory subgroups. We compared baseline characteristics and clinical findings between patterns and between Persistent fluctuating and Episodic subgroups.
Results: All but two patients could be classified into one of the 16 subgroups, with 94% in the Persistent fluctuating or Episodic patterns. In the largest subgroup, "Mild Persistent fluctuating" (25%), mean (SD) pain intensity was 3.4 (0.6) and mean days with pain 130. Patients grouped as "Moderate Episodic" (24%) reported a mean pain intensity of 2.7 (0.6) and 39 days with pain. Eight of the 16 subgroups each contained less than 1% of the cohort. Patients in the Persistent fluctuating pattern scored higher than the other patterns in terms of reduced function and psychosocial factors.
Conclusions: The same subgroups seem to fit neck and low back pain patients, with pain that typically persists and varies in intensity or is episodic. Patients in a Persistent fluctuating pattern are more bothered by their pain than those in other patterns. The low back pain definitions can be used on patients with neck pain, but with the majority of patients classified into 8 subgroups, there seems to be a redundancy in the original model.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje