Purpose: Identify patients with mechanical neck pain who will demonstrated favorable outcomes following cervical manipulation.
Rule:
Puentedura et al., 2012:
1. Symptom duration of less than 38 days
2. Positive expectation that manipulation will help
3. Side-to-side difference in cervical rotation ROM of 10° or greater
4. Pain with posteroanterior spring testing of the middle cervical spine
Stage of CPR Development: Derivation.
| Variables | Sensitivity | Specificity | +LR | Prob of Success |
| 3 | 0.81 | 0.94 | 13.50 | 90% |
| 4 | 0.50 | 1.00 | ∞ | 100% |
Tseng et al., 2006:
1. Neck Disability Index < 11.5
2. Bilateral involvement
3. Not performing sedentary work > 5 hours a day
4. Feeling better while moving neck
5. Did not feel worse with cervical extension
6. Diagnosis of spondylosis without radiculopathy
Stage of CPR Development: Derivation.
| Variables | Sensitivity | Specificity | +LR | Prob of Success |
| 1 | 0.02 | 0.75 | 0.07 | 10% |
| 2 | 0.08 | 0.57 | 0.20 | 23% |
| 3 | 0.43 | 0.78 | 1.93 | 74% |
| 4 | 0.40 | 0.93 | 5.33 | 89% |
| 5 | 0.07 | 1.00 | ∞ | 100% |
Continued Learning…
Continued Reading…
John Snyder, DPT 