2012 Annual Conference

Boucher, Brenda

Texas State University, San Marcos, TX

The objectives of this study are twofold: 1) to determine if a select group of student physical therapists (SPTs) treating patients with primary complaint of cervical pain practice in a manner consistent with the current best evidence related to treatment-based classifications, and 2) to compare treatment outcomes of a select group of SPTs treating patients with primary complaint of cervcial pain with outcomes reported in the published literature.

Subjects consisted of 21 patients (16 females, 76%) with primary complaint of cervical pain treated at various outpatient physical therapy facilities.  The majority (68%) of patients were aged 40-59 years (range= 30-70 years).

Four student physical therapists collected 21 data sets for patients with primary complaint of neck pain over a 9 month period of student clinical affiliations. Patients were classified into one of five treatment classifications using the classification decision-making algorithm proposed by Fritz and Brennan. Neck Disability Index (NDI) and Numeric Pain Rating Scale (NPRS) scores were collected during the initial, weekly and final treatment sessions along with descriptive data on interventions. Interventions were determined by the patient's particular classification and were consisent with treatment recommendations proposed by Fritz and Brennan. 

Descriptive data were collected and analyzed using Microsoft Excel.  Variables of interest were group classification along with change from initial to final NDI and NPRS scores.  These values were compared against outcomes reported by Fritz and Brennan to assess whether student physical therapists achieved similar outcomes using interventions proposed in the treatment-based classification system.

A total of 21 patients met the criteria to be included in this study.  18 of 21 patients received matched treatments according to the classification system.  Patients reported clinically significant reductions in NPRS scores (MCID > 1.3) across all five categories.  Additionally, patients in the Pain Control and Mobilization categories reported clinically significant changes in NDI scores (MCID > 16%). 

In this study, student physical therapists were found to use current best practice patterns to treat patients with primary complaint of cervical pain.  Specifically, student physical therapists were most often found to treat patients with primary complaint of cervcial pain using the treatment-based classification system proposed by Fritz and Brennan.  The results of this study showed clincally significant reductions in pain across all five categories as measured by NPRS scores and clinically significant improvement in function as measured by NDI scores. Treatment outcomes were found to be similar to those reported by Fritz and Brennan, suggesting student physical therapists who treat using best evidence practice patterns yield outcomes consistent with that reported in the published literature.