ANIMO

A cohort study that evaluated usual care manual therapy (MEC-2007-359). In total, 345 manual therapists in the Netherlands recruited 1311 consecutive patients between 18 and 80 years presenting with with non-specific neck pain of any duration. Participating patients received usual care multimodal manual therapy which may have included specific joint mobilizations, high velocity thrust techniques, myofascial techniques, giving advice, or specific exercises.

Background
Prognostic prediction models can support clinicians in their clinical decisions. They intend to distinguish patients with an unfavourable course from those with a favourable course; have potential to decrease patients’ burden; and can make contributions to cost-effective health care.

Hypothesis
Our aims are to validate promising prognostic models for recovery of neck pain in primary care in the ANIMO cohort and to develop prognostic models that predict neck pain recovery in physiotherapy in the ANIMO cohort.

Methods
In the ANIMO cohort, manual therapists in the Netherlands recruited consecutive patients between 18 and 80 years presenting with with non-specific neck pain of any duration. Participating patients received usual care multimodal manual therapy.

Outcomes
Three outcome measures from ANIMO were used: pain as an NRS (10-point Likert scale), NDI-DV (0-50 scale range), and Global Perceived Effect (GPE) measured on a 7-point Likert scale.

For the external validation study on promising neck pain models for recovery we used the GPE and NDI. For the development study, we dichotomized the three outcome measures: NRS into > 2 for non-recovery and ≤ 2 for recovery; NDI into < 8% for recovery and ≥ 8% for non-recovery; GPE recovery into “completely recovered” or “much improved”, non-recovery by responses “slightly improved”, “no change”, “slightly worse”,” much worse”, and “worse than ever”.

Partly supported by a program grant of the Dutch Arthritis Foundation.

SOMT University of Physiotherapy, Amersfoort.

Department of Epidemiology and Data Science, VU University Medical Center, Amsterdam.

Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences.

Department of Physiotherapy, Human physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Brussels.

Center for Muscle and Joint Health, University of Southern Denmark, Odense M, Denmark.

University of Technology Sydney, Sydney, Australia.

Wingbermühle RW, van Trijffel E, Nelissen PM, Koes B, Verhagen, AP. Few promising multivariable prognostic models exist for recovery of people with non-specific neck pain in musculoskeletal primary care: a systematic review. Journal of Physiotherapy. 2018;64: 18-23.

Wingbermühle RW, Chiarotto A, Koes B, Heymans MW, van Trijffel E. Challenges and solutions in prognostic prediction models in spinal disorders. Journal of Clinical Epidemiology, Accepted.

Dr. E. van Trijffel (co-promotor), e.vantrijffel@somtuniversity.nl
Dr. A. Chiarotto (co-promotor), a.chiarotto@erasmusmc.nl
Prof. Dr. A. P. Verhagen, arianne.verhagen@uts.edu.au
Dr. M.W.H. Heijmans, mw.heymans@amsterdamumc.nl
Prof. Dr. B. W. Koes (promotor), b.koes@erasmusmc.nl

Contact address for the project: r.wingbermuhle@erasmusmc.nl.