Patients with neck pain who are likely to respond to home-based mechanical cervical traction (HMCT) might be identified with a clinical predication rule, say authors of an article published online ahead of print January 15 in European Spine Journal. 

A physical therapy clinic at a Singapore hospital conducted the prospective cohort study, which included patients with neck pain referred to the clinic for physical therapy. A HMCT program was given to participants for 2 weeks. The patient's demographic data, Numerical Pain Scale (NPS) score, Neck Disability Index (NDI), and Fear-Avoidance Beliefs Questionnaire score were collected, and standard physical examination of the cervical spine was conducted before intervention. The NPS score, NDI, and a global rating of perceived improvement were collected after the intervention was completed. A total of 103 patients participated in the study; 47 had a positive response to HMCT. A clinical prediction rule with 4 variables (Fear-Avoidance Beliefs Work Subscale score < 13, pre-intervention pain intensity ≥ 7/10, positive cervical distraction test, and pain below shoulder) was identified. With satisfaction of at least 3 out of 4 variables (positive likelihood ratio = 4.77), the intervention's success rate increased from 45.6% to more than 80%.