ENQUÊTE DESCRIPTIVE DES CARACTÉRISTIQUES CLINIQUES DES CERVICALGIES CHRONIQUES
Background: Neck pain is a major health burden and one of the most common reasons to consult a health professional1, such as physical therapy (PT). In rehabilitation, better outcomes are obtained when PT treatments are driven by non-specific diagnosis, such as when patients are classified according to their clinical presentation. The intention behind the use of a classification system is to help therapists classify patients into homogenous subgroups following a symptoms-based evaluation. A recent clinical practice guideline has embraced this type of classification for the diagnosis and treatment of patients with neck pain1. One example of such classification system …show more content…
Patients who fall under the derangement subgroup are said to have a directional preference (DP) and can present with or without the phenomenon of centralization (CEN)2. CEN and DP are key features to identify, as they are associated with a good prognosis and better outcomes3. Patients who don’t fall under one of those 3 mechanical syndromes are classified into the “other” subgroup2. Although this classification has been shown to be very useful for improving outcomes for lumbar spine problems, much less research has been done for the cervical spine, and even less for chronic neck pain (>6 months). While the MDT classification includes a chronic pain category in its other subgroup, it does not explicitly incorporate the concepts of central sensitization (CS)4 very often associated with chronic painful conditions. CS is defined as “an amplification of neural signalling within the central nervous system that elicits pain hypersensitivity”. Since the presence of CS requires specific treatment approach, screening for CS in a population at high risk of presenting CS is essential. Yet, its presence in …show more content…
(2) Clinical characteristics: Pain intensity and perceived disability will be obtained using a standard VAS scale and the Neck disability index (NDI) questionnaire respectively. Patient’s age, sex, duration of symptoms and cervical range of motion will also be collected. (3) Central sensitization: the Central Sensitization Inventory Questionnaire (CSI)6, a valid and reliable tool, will be used to screen for patients having potential CS. (4) Psychosocial barriers: Their presence will be measured with the Tampa Scale of Kinesiophobia (TSK) and the Pain Catastrophizing Scale (PCS), two validated tools that have been used in previous studies5. Survey tool: Consists of an online survey that will gather data about therapist characteristics (ie: years of experience with the MDT system, area of practice) and sociodemographic information about the patients (ie: age, sex). Procedures: Once consent forms are obtained, therapists will be asked to evaluate ≈10 consecutive admissible patients. After the physical evaluation, psychosocial questionnaires will be completed by the patients and then be returned to the therapist. Ethical consideration: All the data will be kept anonymous.
Background: Neck pain is a major health burden and one of the most common reasons to consult a health professional1, such as physical therapy (PT). In rehabilitation, better outcomes are obtained when PT treatments are driven by non-specific diagnosis, such as when patients are classified according to their clinical presentation. The intention behind the use of a classification system is to help therapists classify patients into homogenous subgroups following a symptoms-based evaluation. A recent clinical practice guideline has embraced this type of classification for the diagnosis and treatment of patients with neck pain1. One example of such classification system …show more content…
Patients who fall under the derangement subgroup are said to have a directional preference (DP) and can present with or without the phenomenon of centralization (CEN)2. CEN and DP are key features to identify, as they are associated with a good prognosis and better outcomes3. Patients who don’t fall under one of those 3 mechanical syndromes are classified into the “other” subgroup2. Although this classification has been shown to be very useful for improving outcomes for lumbar spine problems, much less research has been done for the cervical spine, and even less for chronic neck pain (>6 months). While the MDT classification includes a chronic pain category in its other subgroup, it does not explicitly incorporate the concepts of central sensitization (CS)4 very often associated with chronic painful conditions. CS is defined as “an amplification of neural signalling within the central nervous system that elicits pain hypersensitivity”. Since the presence of CS requires specific treatment approach, screening for CS in a population at high risk of presenting CS is essential. Yet, its presence in …show more content…
(2) Clinical characteristics: Pain intensity and perceived disability will be obtained using a standard VAS scale and the Neck disability index (NDI) questionnaire respectively. Patient’s age, sex, duration of symptoms and cervical range of motion will also be collected. (3) Central sensitization: the Central Sensitization Inventory Questionnaire (CSI)6, a valid and reliable tool, will be used to screen for patients having potential CS. (4) Psychosocial barriers: Their presence will be measured with the Tampa Scale of Kinesiophobia (TSK) and the Pain Catastrophizing Scale (PCS), two validated tools that have been used in previous studies5. Survey tool: Consists of an online survey that will gather data about therapist characteristics (ie: years of experience with the MDT system, area of practice) and sociodemographic information about the patients (ie: age, sex). Procedures: Once consent forms are obtained, therapists will be asked to evaluate ≈10 consecutive admissible patients. After the physical evaluation, psychosocial questionnaires will be completed by the patients and then be returned to the therapist. Ethical consideration: All the data will be kept anonymous.