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Predictors of failure to achieve minimal clinical important difference for pain and disability after mechanical diagnosis and therapy (MDT)-based multimodal rehabilitation for neck pain: a retrospective analysis of 4998 patients

European Spine Journal volume 31, pages 1291–1299 (2022)Cite this article

Abstract

Purpose

To determine predictors of failure to achieve minimal clinical important difference (MCID) for pain and disability at discharge after mechanical diagnosis and therapy (MDT)-based multimodal rehabilitation for neck pain (NP).

Methods

Pre- and post-treatment numerical pain rating scale (NPRS) and neck disability index (NDI) in patients with mechanical NP were analysed in this retrospective study. Multivariate analysis was performed to investigate the effect of covariates such as age, gender, lifestyle, body mass index, presentation, diabetes, osteoporosis, response to repeated movement testing, treatment sessions, compliance rate, and pre-treatment NPRS and NDI scores on failure to achieve MCID of ≥ 30% for NPRS and NDI scores post-treatment.

Results

In the 4998 patients analysed for this study, 7% and 14.5% of patients failed to achieve MCID for NPRS and NDI scores, respectively, at the end of treatment. Age > 70 years, diabetes, osteoporosis, partial or non-response to repeated movements, lesser treatment sessions, and lower compliance rate were associated with increased risk for failure to achieve MCID for NPRS and NDI scores. A higher pre-treatment NDI score was associated with failure to achieve MCID for NPRS score, whereas lower pre-treatment NPRS and NDI scores were associated with failure to achieve MCID for NDI score.

Conclusion

Although MDT-based multimodal rehabilitation helped to achieve significant reduction in pain and disability in mechanical NP, several baseline risk factors were associated with failure to achieve MCID for pain and disability after treatment. Identifying and modifying these factors as part of rehabilitation treatment may help to achieve better outcomes in mechanical NP.

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Data availability

All data and material related to the current study are available from the corresponding author on reasonable request.

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Funding

No benefits or funds were received in support of this study by any of the authors.

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Authors and Affiliations

  1. QI Spine Clinic, #6 Level 2 Phoenix Market City, LBS Road, Kamani, Kurla (West), Mumbai, 400070, India

    Gautam M. Shetty, Palak Vakil, Shikha Jain & Garima Anandani

  2. I.T.S College of Physiotherapy, Ghaziabad, India

    C. S. Ram

Authors
  1. Gautam M. Shetty
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  2. Palak Vakil
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Correspondence to Gautam M. Shetty.

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Informed consent was taken from all patients regarding the use of their anonymized demographic and clinical data for this study.

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Informed consent was taken from all patients regarding publication of their anonymized demographic and clinical data for this study.

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Shetty, G.M., Vakil, P., Jain, S. et al. Predictors of failure to achieve minimal clinical important difference for pain and disability after mechanical diagnosis and therapy (MDT)-based multimodal rehabilitation for neck pain: a retrospective analysis of 4998 patients. Eur Spine J 31, 1291–1299 (2022). https://doi.org/10.1007/s00586-022-07167-1

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  • DOI: https://doi.org/10.1007/s00586-022-07167-1

Keywords

  • Prognosis
  • Rehabilitation
  • Physical therapy
  • Mechanical neck pain
  • Multimodal treatment