Article

OBJECTIVE: To conduct a systematic review and meta-analysis on the prognosis of
acute idiopathic neck pain and disability. DATA SOURCES: EMBASE, CINAHL, Medline,
AMED, PEDro, and CENTRAL were searched from inception to July 2009, limited to
human studies. Reference lists of relevant systematic reviews were searched by
hand. Search terms included: neck pain, prognosis, inception, cohort,
longitudinal, observational, or prospective study and randomized controlled trial. STUDY SELECTION: Eligible studies were longitudinal cohort studies and
randomized controlled trials with a no treatment or minimal treatment arm that
recruited an inception cohort of acute idiopathic neck pain and reported pain or
disability outcomes. Eligibility was determined by 2 authors independently. Seven
of 20,085 references were included. DATA EXTRACTION: Pain and disability data
were extracted independently by 2 authors. Risk of bias was assessed
independently by 2 authors. DATA SYNTHESIS: Statistical pooling showed a weighted
mean pain score (0-100) of 64 (95% confidence interval [CI], 61-67) at onset and
35 (95% CI, 32-38) at 6.5 weeks. At 12 months, neck pain severity remained high
at 42 (95% CI, 39-45). Disability reduced from a pooled weighted mean score
(0-100) at onset of 30 (95% CI, 28-32) to 17 (95% CI, 15-19) by 6.5 weeks,
without further improvement at 12 months. Studies varied in length of follow-up,
design, and sample size. CONCLUSIONS: This review provides Level I evidence that
the prognosis of acute idiopathic neck pain is worse than currently recognized.
This evidence can guide primary care clinicians when providing prognostic
information to patients. Further research to identify prognostic factors and
long-term outcomes from inception cohorts would be valuable.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS