337: Predictors factors of physiotherapy success in chronic neck pain: A Systematic Review

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Physiotherapy (e.g. exercise, rehab), Artificial Intelligence/Machine Learning

Background and Aims: Neck pain (NP) is a huge problem in modern industrialized countries, around 54% of the population is affected, from those a further 5% suffer from severe pain (1). Predictive factors of treatment success can inform the development of effective, personalized therapy, thereby improving decision-making (2). As far of the authors’ knowledge, there is no systematic review (SR) published that cover prediction analysis for adult patients with neck pain. Consequently, the aim of this SR is to compile, assess, and synthesize the available evidence about predictive factors for treatment success for patients with chronic non-specific neck pain after physical therapy treatment.

Methods: This project adhered to the PRISMA guidelines and was registered in PROSPERO (CRD420251053428). A health librarian conducted all searches using the following databases: Medline, Embase, CINAHL, CENTRAL, and Scopus. Studies were included if they involved adults with non-specific chronic neck pain, evaluated predictive factors, and measured treatment success after physiotherapy using any available tool. Screening and data extraction were performed using Covidence. The entire process, including screening, data extraction, quality assessment (PROBAST+IA), and evaluation of the certainty of the evidence, was conducted by two independent assessors.

Results: From 3,491 records, 13 studies were included. Outcomes assessed were pain intensity (3 studies), neck disability (6), self-perception of improvement (5), and other outcomes (i.e., self-reported improvement criteria, pain, and disability) assessed by one study. In total, 129 factors were analyzed. Four factors showed a positive association in more than one study and were statistically significant: sex, age, neck disability (NDI), and pain intensity. Three factors showed a negative association across multiple studies: BMI, NDI, and age; however, only age was statistically significant. Age and NDI were associated with both positive and negative outcomes, highlighting inconsistency in their predictive role.

Conclusions: The results suggest that personal factors and characteristics of the condition may be related to physiotherapy treatment success; however, only age was consistently significant. Other factors, including catastrophizing, anxiety, depression, analgesic use, global movement measures, lumbar pain, headaches, and whiplash, were significantly associated with outcomes in single studies only. These findings should be interpreted cautiously due to high risk of bias and very low certainty of evidence. Therefore, higher-quality studies in this area are needed.

References: (1) Ylinen J. Physical exercises and functional rehabilitation for the management of chronic neck pain. Eura Medicophys 2007; 43: 119-132.
(2) Simms L, Barraclough H and Govindan R. Biostatistics primer: what a clinician ought to know--prognostic and predictive factors. J Thorac Oncol 2013; 8: 808-813. DOI: 10.1097/JTO.0b013e318292bdcd.

Presenting Author: Ester Moreira de Castro-Carletti
Submitting Author: Ester Castro Carletti

Senior Author: Susan Armijo-Olivo

IASP 2026 Global Year theme of Neuropathic Pain: No

• Ester Moreira de Castro-Carletti: Dr - University of Applied Sciences, Faculty of Business and Social Sciences, Osnabrück, Germany
• Constanze Muke: NA - University of Applied Sciences, Faculty of Business and Social Sciences, Osnabrück, Germany
• Elisa Dürken: NA - University of Applied Sciences, Faculty of Business and Social Sciences, Osnabrück, Germany
• Liz Dennett: Dr - Geoffrey and Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
• Bernhard Taxer: Dr. - Medical University of Salzburg, Christian Doppler Clinics for Neurology, Austria
• Nikolaus Ballenberger: Dr - University of Applied Sciences, Faculty of Business and Social Sciences, Osnabrück, Germany
• Susan Armijo-Olivo: Dr - University of Applied Sciences, Faculty of Business and Social Sciences, Osnabrück, Germany; Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, Alberta, Canada