PT Treatment Dosage Based on Classification for Neck Pain PatientsHow long should you see a physical therapist (PT) for neck pain? And how come some neck pain patients get better faster than others? In this study, PTs from Australia try to answer these and other questions about physical therapy treatment dose.
Two groups of neck pain patients were included. All had neck pain from an unknown cause. Anyone with neck pain from car accidents or other trauma was not included. The patients were divided into two groups based on their symptoms.
The first group had pain with movement or activity. The second group had load-bearing pain. Their pain was made worse with prolonged postures or sustained positions such as sitting.
The therapists treating the patients did not know which group each patient was in. Each patient was treated by one of four PTs. The treatment was determined by each PT for each patient. Results were measured by pain levels, function, and disability.
The number of treatment sessions called treatment dose were added up and compared to the results for the two groups. The authors report that patients in the loading group got better faster. They were much more likely to be discharged from PT before the movement group.
Treatment for the movement group lasted an average of eight weeks. This compared to four weeks for the loading group. Patients in both groups had equal decrease in pain intensity and improvement in function.
The authors conclude that a simple classification of neck pain based on load-versus-movement can be used to predict treatment dosage. Patients with pain but full motion need 35 per cent fewer treatments compared with patients who have pain and loss of motion.
The results of this study agree with other reports that time spent with the patient is not the main factor in their response to treatment. Therapists should make sure patients get the best response from care before discharging them. They can expect that neck pain patients with movement impairments may take longer to get the same response as patients with loading pain only.
Dean A. Clair, PT, MMedSc, et al. Physical Therapy Treatment Dose for Nontraumatic Neck Pain: A Comparison Between 2 Patient Groups. In Journal of Orthopaedic & Sports Physical Therapy. November 2006. Vol. 36. No. 11. Pp.867-875.
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