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Background: To ensure the validity and therapeutic utility of the Neck disability index (NDI) scale, translations, cultural adaptations and psychometric evidence is necessary. This study aimed to address the absence of a suitable and validated Hindi version of the NDI for the rural population. The specific objectives were to translate, adapt, and evaluate the psychometric properties of the newly developed Hindi version of the NDI., Methods: Following guidelines provided by the American Association of Orthopedic Surgeons, the original English NDI scale was cross-culturally adapted into Hindi. The adaptation process included translations (forward and backward), expert committee review, pre-testing and cognitive debriefing with 30 individuals experiencing chronic non-specific neck pain. The outcome of this process was the creation of the Hindi version of the NDI, termed NDI-Hi. Subsequently, NDI-Hi was administered to 211 participants with neck pain from multiple centers for psychometric testing. The evaluation involved test-retest reliability over a 48-hour interval, factor analysis, assessment of internal reliability measures, and criterion-related validity by comparing it with the NPAD-Hindi version., Results: The NDI-Hi version exhibited favorable psychometric properties, including good test-retest reliability with an intra-class correlation coefficient (ICC) of 0.87. Internal consistency of the scale was high, indicated by Cronbach's alpha coefficient (α) of 0.96. The standard error of measurement (SEM) was determined to be 2.58, and the minimal detectable change (MDC) was calculated to be 7.15. Furthermore, the NDI-Hi showed significant correlation with the NPAD-Hindi version, with a correlation coefficient (rho) of 0.86, and a p-value of less than 0.001., Conclusions: The NDI-Hi demonstrated validity and reliability as an outcome tool for assessing neck disability. It can be effectively utilized in clinical practice and research settings involving Hindi-speaking individuals with chronic non-specific neck pain. The adapted scale is particularly well-suited for the rural Northern Indian Hindi-speaking population., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Sidiq M et al.)

Background: Computer professionals often develop a forward head posture due to prolonged hours of computer use, leading to neck pain. Instrument-assisted soft tissue mobilization (IASTM), an advanced technique for treating myofascial trigger points, has become increasingly popular for addressing these musculoskeletal issues., Objectives: The study aimed to compare the effectiveness of IASTM mobilization on SBAL (superficial back arm line) and SM(specific muscles-upper trapezius, levator scapulae, and sternocleidomastoid) in managing chronic neck pain among computer professionals., Participants & Methods: The study involved 62 computer professionals, randomly divided into two groups. Group A received IASTM on SBAL and group B received IASTM on SM for neck pain each receiving three sessions weekly for four weeks. Outcome variables like Neck Disability Index (NDI), NPRS(Neck Pain Rating Scale), Craniovertebral angle (CVA), and range of motion (ROM) for flexion, and side flexion (right & left side) were evaluated at baseline, 2 weeks and 4 weeks., Results: Significant improvement in NPRS were observed in both the SBAL and SM groups after 2 weeks of IASTM, wth the SBAL group demonstrating greater improvement. At 4 weeks, IASTM on SBAL showed significantly higher improvements in NPRS, CVA, NDI, and flexion compared to the SM group. The repeated measures ANOVA indicated a significant main effect of both time and group, along with a significant interaction between time and group for all outcome variables, except for CVA., Conclusion: The study indicates that IASTM on SBAL may offer a more effective treatment for chronic neck pain in computer professionals compared to targeting specific muscles., Competing Interests: Declaration of competing interest “No financial, legal, or political conflicts involving third parties (government, corporations, private foundations, etc.) have been declared for any aspect of the submitted work (including, but not limited to grants and funding, advisory board participation, study design, preparation of the manuscript, statistical analysis, etc.)”. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript., (Copyright © 2024. Published by Elsevier Ltd.)

Introduction: Mechanical neck pain has become prevalent among computer professionals possibly because of prolonged computer use. This study aimed to investigate the relationship between neck pain intensity, anthropometric metrics, cervical range of motion, and related disabilities using advanced machine learning techniques., Method: This study involved 75 computer professionals, comprising 27 men and 48 women, aged between 25 and 44 years, all of whom reported neck pain following extended computer sessions. The study utilized various tools, including the visual analog scale (VAS) for pain measurement, anthropometric tools for body metrics, a Universal Goniometer for cervical ROM, and the Neck Disability Index (NDI). For data analysis, the study employed SPSS (v16.0) for basic statistics and a suite of machine-learning algorithms to discern feature importance. The capability of the kNN algorithm is evaluated using its confusion matrix., Results: The "NDI Score (%)" consistently emerged as the most significant feature across various algorithms, while metrics like age and computer usage hours varied in their rankings. Anthropometric results, such as BMI and body circumference, did not maintain consistent ranks across algorithms. The confusion matrix notably demonstrated its classification process for different VAS scores (mild, moderate, and severe). The findings indicated that 56% of the pain intensity, as measured by the VAS, could be accurately predicted by the dataset., Discussion: Machine learning clarifies the system dynamics of neck pain among computer professionals and highlights the need for different algorithms to gain a comprehensive understanding. Such insights pave the way for creating tailored ergonomic solutions and health campaigns for this population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Khanum, Khan, Khan, Aafreen, Khan, Ahmad, Akhtar, Farooq, Shaphe, Alshehri, Shahi, Alqahtani, Albakri and Obaidat.)

Objective: We sought to quantify the neck-related disability in adult women with Chiari malformation type I and identify the significantly related variables., Methods: A total of 70 variables were selected from the self-report history questionnaires (12 variables; n = 474), standardized scales (15 variables; n = 474), and morphometric data (43 variables; n = 293-474) of adult women with Chiari malformation type I. The variables were tested independently to identify those with a significant relationship to the Neck Disability Index (NDI; P < 0.00071) and those that might be associated with the NDI (P < 0.05). A forward selection regression model was constructed to identify the variables contributing unique variance to the NDI. In addition, a mediation analysis was performed to determine whether depression mediated the relationship between pain and disability., Results: Overall, 79.5% of the patients had scored at a moderate level of disability or higher. Independent testing identified 16 significant variables, including symptom duration, tonsillar position, and measures of psychological distress. The short-form McGill pain questionnaire-2 (r = 0.69; P < 0.00001) and CES-D scale for depression (r = 0.56; P < 0.00001) exhibited the highest correlations with the NDI. The forward selection regression model produced an R 2 of 0.6178. Pain and depression accounted for more than one half of the NDI variance., Conclusions: We found that high levels of disability are common among adult women with Chiari malformation type I, independent of surgical status. Pain and depression were the primary factors related to this disability. Depression mediated the relationship between pain intensity and disability at a modest level (5%). Patients who had experienced symptoms for >2 years before diagnosis had had, on average, 77% higher NDI scores, highlighting the importance of a timely diagnosis., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background Context: Although anterior cervical discectomy and fusion is believed to positively impact a patient's radicular symptoms as well as axial neck pain, the outcomes of cervical disc replacement (CDR) with regards to neck pain specifically have not been established., Purpose: Primary: to assess clinical improvement following CDR in patients with neck pain greater than arm pain. Secondary: to compare the clinical outcomes between patients undergoing CDR for predominant neck pain (pNP), predominant arm pain (pAP), and equal neck and arm pain (ENAP)., Study Design: Retrospective review of prospectively collected data., Patient Sample: Patients who had undergone one- or two-level CDR for the treatment of degenerative cervical pathology and had a minimum of 6-month follow-up were included and stratified into three cohorts based on their predominant location of pain: pNP, pAP, and ENAP., Outcome Measures: Patient-reported outcomes: Neck Disability Index (NDI), Visual Analog Scale (VAS) neck and arm, Short Form 12-Item Physical Health Score (SF12-PHS), Short Form 12-Item Mental Health Score (SF12-MHS), minimal clinically important difference (MCID)., Methods: Changes in Patient-reported outcomes from preoperative values to early (<6 months) and late (≥6 months) postoperative timepoints were analyzed within each of the three groups. The percentage of patients achieving MCID was also evaluated., Results: One hundred twenty-five patients (52 pNP, 30 pAP, 43 ENAP) were included. The pNP cohort demonstrated significant improvements in early and late NDI and VAS-Neck, early SF-12 MCS, and late SF-12 PCS. The pAP and ENAP cohorts demonstrated significant improvements in all PROMs, including NDI, VAS-Neck, VAS-Arm, SF-12 PCS, and SF-12 MCS, at both the early and late timepoints. No statistically significant differences were found in the MCID achievement rates for NDI, VAS-Neck, SF-12 PCS, and SF-12 MCS at the late timepoint amongst the three groups., Conclusions: CDR leads to comparable improvement in neck pain and disability in patients presenting with neck pain greater than arm pain and meeting specific clinical and radiographic criteria., Competing Interests: Declarations of competing interests The authors report no conflicts of interest relevant to the topic of this study., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Health domains like pain, disability, and health-related quality of life are commonly used outcomes for musculoskeletal disorders. Most prognostic studies include only one outcome, and it is unknown if prognostic factors and models may be generic across different outcomes. The objectives of this study were to examine the correlation among commonly used outcomes for neck pain (pain intensity, disability, and health-related quality of life) and to explore how the predictive performance of a prognostic model differs across commonly used outcomes., Methods: We conducted an observational prospective cohort study with data from patients with neck pain aged 18-84 years consulting Norwegian chiropractors. We used three different outcomes: pain intensity (Numeric Pain Rating Scale), the Neck Disability Index (NDI), and health-related quality of Life (EQ-5D). We assessed associations between change in outcome scores at 12-weeks follow-up with Pearson's correlation coefficient. We used multivariable linear regression models to explore differences in explained variance and relationship between predictors and outcomes., Results: The study sample included 1313 patients and 941 (72%) completed follow-up at 12 weeks. The strongest correlation was between NDI and EQ-5D (r = 0.57) while the weakest correlation was between EQ-5D and pain intensity (r = 0.39). The correlation between NDI and pain intensity was moderate (r = 0.53) In the final regression models, the explained variance ranged from adjusted R 2 of 0.26 to 0.60, highest with NDI and lowest with pain intensity as outcome. The predictive contributions of the included predictors were similar across outcomes. Among the investigated predictors, pain patterns and the baseline measure of the corresponding outcome measure contributed the most to explained variance across all outcomes., Conclusions: The highest correlation was found between NDI and EQ-5D and the lowest with pain intensity. The same prognostic model showed highest predictive performance with NDI as outcome and poorest with pain intensity as outcome. These results suggest that we need more knowledge on the reasons for the differences in predictive performance variation across outcomes., (© 2022. The Author(s).)

Background: The SANE is a PROM of recovery, which may assist clinicians in clinical decision-making and discharge planning. The psychometric measurement properties of the SANE have yet to be determined for neck pain., Objectives: Threefold objectives included: 1)determine the numerical threshold for the SANE at which patients with neck pain determine their symptoms are acceptable; 2)determine the association between scores for the NDI and VAS, with the SANE; 3)determine the average number of visits, costs and value associated with the management of neck pain., Design: Longitudinal repeated measures cohort design., Methods: Threshold measures for self-reported recovery with the SANE anchored to the PASS were examined using ROC. PCC determined the relationship between the VAS/pain and NDI raw/percentage change scores and the SANE at discharge. Descriptive statistics were used for number of visits and cost. Value was calculated as the proportion of change on the NDI and VAS/$100 US dollars spent., Results: 57 subjects completed full observation. ROC analysis indicates a threshold value of 82.5%(Sn = 56.0, Sp = 85.7,+LR = 1.68,-LR = 0.29) on the SANE with an AUC of 0.820(95%CI = 0.638, 1.00). A weak correlation was found between raw NDI(r = 0.39 p < 0.05)/Pain(r = 0.45 p < 0.05) scores and the SANE with a moderate correlation between percent change scores of NDI(r = 0.52 p < 0.05)/PAIN(r = 0.54 p < 0.05) and the SANE. The value proposition indicated cost of care amounted to a 10.5% and 12.9%; improvement in the NDI and pain scores/$100 spent., Conclusions: Patients reporting greater than 82.5% on the SANE are likely to find their present status acceptable and potentially stop seeking care., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Recurrent or persistent neck pain affects a vast number of people globally, leading to reduced quality of life and high societal costs. Clinically, it is a difficult condition to manage, and treatment effect sizes are often moderate at best. Activity and manual therapy are first-line treatment options in current guidelines. We aimed to investigate the combination of home stretching exercises and spinal manipulative therapy in a multicentre randomized controlled clinical trial, carried out in multidiscipline ary primary care clinics., Methods: The treatment modalities utilized were spinal manipulative therapy and home stretching exercises compared to home stretching exercises alone. Both groups received 4 treatments for 2 weeks. The primary outcome was pain, where the subjective pain experience was investigated by assessing pain intensity (NRS - 11) and the quality of pain (McGill Pain Questionnaire). Neck disability and health status were secondary outcomes, measured using the Neck Disability Indexthe EQ-5D, respectively. One hundred thirty-one adult subjects were randomized to one of the two treatment groups. All subjects had experienced persistent or recurrent neck pain the previous 6 months and were blinded to the other group intervention. The clinicians provided treatment for subjects in both group and could not be blinded. The researchers collecting data were blinded to treatment allocation, as was the statistician performing data analyses. An intention-to-treat analysis was used., Results: Sixty-six subjects were randomized to the intervention group, and sixty-five to the control group. For NRS - 11, a B-coefficient of - 0,01 was seen, indication a 0,01 improvement for the intervention group in relation to the control group at each time point with a p-value of 0,305. There were no statistically significant differences between groups for any of the outcome measures., Conclusion: Based on the current findings, there is no additional treatment effect from adding spinal manipulative therapy to neck stretching exercises over 2 weeks for patients with persistent or recurrent neck pain., Trial Registration: The trial was registered 03/07/2018 at ClinicalTrials.gov , registration number: NCT03576846., (© 2021. The Author(s).)

Introduction: Acupressure is known to be effective for some types of chronic pain. However, the effect of acupressure on chronic neck pain has not been investigated. Accordingly, the authors aimed to evaluate effects of the 4-week acupressure treatment on pain, neck function, and substance P in women with chronic neck pain. Methods: The acupressure treatment was performed two times a week for 4 weeks in an acupressure group ( n  = 24), meanwhile a control group ( n  = 26) was untreated. Before and after intervention, pain intensity and physical disability were measured by visual analogue scale (VAS) and neck disability index (NDI), respectively. In addition, cervical range of motion (CROM) and serum substance P were evaluated. Results: Results of two-way analysis of variance with repeated measures revealed that time × group interactions were significant in all outcomes (all p  < 0.001) except substance P. These results indicate that after 4 weeks, VAS and NDI significantly decreased in the acupressure group compared with those changes in the control group. The CROM values for six cervical movements significantly increased in the acupressure group compared with those changes in the control group. Serum substance P did not change significantly in both groups. However, when the pre- and postintervention data from all subjects were pooled, substance P was significantly correlated with VAS ( r  = 20; p  < 0.05; n  = 100). Conclusions: The 4-week acupressure intervention showed significant reduction in pain and improvement in neck disability and flexibility, suggesting that acupressure intervention is an effective treatment for chronic neck pain. This study was registered with the Korean Clinical Trial Registry and WHO Clinical Trial Registry (KCT0005363).

Objective: Chronic mechanical neck pain is associated with musculoskeletal tissue alterations. Active trigger points in the trapezius and levator scapulae muscles are common in patients with chronic mechanical neck pain. In this study, we compared the effect of dry needling (DN) combined with manual therapy (MT) to sham dry needling (SDN) combined with MT on pain, pain pressure threshold, cervical range of motion and neck disability in patients with chronic mechanical neck pain., Methods: A randomised, single-blind clinical trial was carried out involving 101 participants with chronic mechanical neck pain, divided into an intervention group (DN+MT, n=47) and a control group (SDN+MT, n=54). Participants received two treatment sessions. The intervention group received MT in conjunction with DN of the most mechano-sensitive myofascial trigger point (MTrP). The control group received MT plus SDN. Outcomes measures were: pain intensity (numeric pain rating scale, NPRS), pressure pain threshold (PPT), cervical range of motion (ROM) and neck disability (neck disability index, NDI)., Results: This study found that between-group differences in pain intensity were statistically significant (P<0.01). Pain decreased after the first intervention in the DN+MT group (3.47±0.25 points on the NPRS) and even more so after the second intervention (4.76±0.24 points on the NPRS). After 4 weeks, pain intensity differed from baseline by 4.89±0.27 points on the NPRS. Statistically significant differences (P<0.001) in PPT were also found between the intervention group and the control group. After the first intervention, a significant increase in PPT within the DN+MT group (3.09±0.8 kg/cm 2 ) was observed. Cervical ROM also showed highly statistically significant differences. After 4 weeks, a statistically significant reduction (P<0.001) in NDI was observed between the two groups., Conclusion: Our results show that DN+MT is efficacious and significantly better than SDN+MT at reducing pain intensity, PPT, neck disability and cervical ROM in patients with chronic mechanical neck pain., Level of Evidence: 1b.

Objective: Several efforts have been made to investigate the long-term efficacy of artificial disc replacement surgery compared with that of fusion after decompression for the treatment of cervical degenerative disc disease and radiculopathy. However, research on the impact of mental distress on surgical treatment outcome has been sparse. The aim of the authors was to investigate the potential predictive value of preoperative risk factors in determining long-term outcome., Methods: A total of 153 patients (mean age 47 years) with single- or double-level cervical degenerative disc disease and radiculopathy were randomly assigned to undergo either anterior cervical discectomy and fusion (n = 70) or artificial disc replacement (n = 83). The primary outcome was the Neck Disability Index (NDI) score, a patient-reported function score that ranges from 0% to 100%; higher scores indicate greater disability. Preoperative variables such as sex, age, smoking status, employment status, having a strenuous job, neck pain duration, arm pain duration, amount of regular exercise, Hospital Anxiety and Depression Scale (HADS) score, NDI score, whether surgery was performed on 1 or 2 levels, and allocated treatment were analyzed in multiple linear regression models with the 5-year NDI score as the outcome., Results: A total of 47 (31%) patients had either a HADS anxiety or HADS depression score of 10 points or higher. High values on the preoperative HADS were a negative predictor of outcome (p = 0.009). Treatment allocation had no effect on 5-year NDI scores (p = 0.32)., Conclusions: Preoperative mental distress measured with the HADS affects long-term outcome in surgically treated patients with cervical radiculopathy.

Objective: The Neck Disability Index (NDI) is commonly used for clinical and research assessment for chronic neck pain, yet the original version of this tool has not undergone significant validity testing, and in particular, there has been minimal assessment using Item Response Theory. The goal of the present study was to investigate the psychometric properties of the original version of the NDI in a large sample of individuals with chronic neck pain by defining its internal consistency, construct structure and validity, and its ability to discriminate between different degrees of functional limitation., Methods: This is a cross-sectional cohort study of 585 consecutive patients with chronic neck pain seen in a university hospital rehabilitation clinic. Internal consistency was evaluated using Cronbach's alpha, construct structure was evaluated by exploratory factor analysis, and discrimination ability was determined by Item Response Theory., Results: The NDI demonstrated good internal consistency assessed by Cronbach's alpha (0.87). The exploratory factor analysis identified only one factor with eigenvalue considered significant (cutoff 1.0). When analyzed by Item Response Theory, eight out of 10 items demonstrated almost ideal difficulty parameter estimates. In addition, eight out of 10 items showed high to perfect estimates of discrimination ability (overall range 0.8 to 2.9)., Conclusions: Amongst patients with chronic neck pain, the NDI was found to have good internal consistency, have unidimensional properties, and an excellent ability to distinguish patients with different levels of perceived disability. Implications for Rehabilitation The Neck Disability Index has good internal consistency, unidimensional properties, and an excellent ability to distinguish patients with different levels of perceived disability. The Neck Disability Index is recommended for use when selecting patients for rehabilitation, setting rehabilitation goals, and measuring the outcome of intervention.

Background: Multiwave locked system (MLS) laser therapy utilizes the synchronized emission of an 808 nm continuous laser and a 905 nm pulsed laser. It is postulated that MLS enables greater penetration and therapeutic benefit than single-wavelength low-level laser therapy (LLLT)., Objective: The aim of this research was to evaluate the efficacies of MLS laser therapy and the 830 nm laser in the treatment of patients with chronic neck pain (CNP)., Materials and Methods: Seventy-five patients with CNP (mean age 46.28 ± 5.89, weight 83.78 ± 5.65 kg, height 1.72 ± 4.96 m, and duration of illness of 5.98 ± 1.44 months). They were randomized into three groups. Group I received MLS laser therapy and exercises, Group II received LLLT and exercises, and Group III received placebo laser therapy plus exercises (PL + EX). Neck pain levels and neck function were measured using the visual analogue scale (VAS) and neck disability index (NDI), respectively., Results: Both VAS and NDI were significantly reduced post-treatment for all treatment groups. After 6 weeks of treatment, MLS plus exercise showed a significantly greater decrease in pain and disability scores {Δ VAS (6.68) and Δ NDI (39.84)} compared to both LLLT plus exercise group {Δ VAS (5.72) and Δ NDI (37.88)} and PL + EX {Δ VAS (4.84) and Δ NDI (36.68)}., Conclusions: MLS laser therapy in conjunction with exercises decreased pain and increased functional activity following 6 months of therapy. MLS laser therapy in combination with exercises is a more effective therapy for CNP compared to exercise plus LLLT or exercise alone.

Objective: To (1) translate and culturally adapt and (2) determine the clinimetric properties of the Danish 8-item Neck Disability Index (NDI-8) in primary sector patients (PSPs) and secondary sector patients (SSPs)., Methods: Analyses included 326 patients with neck pain. Validity and reliability were assessed using a cross-validation factor analytical design, hypothesis testing, internal consistency, measurement error, the smallest detectable change (SDC), and a generalizability study. Criterion and construct responsiveness, minimal important change (MIC), and floor and ceiling effects were determined., Results: The original Danish version of the NDI was not unidimensional. Omitting 2 items (pain, headache) revealed a 1-factor structure (NDI-8). Construct validity correctly predicted 88% of the hypotheses. Internal consistency (Cronbach's α) ranged between 0.88 and 0.89, and generalizability was high (Φ = 0.90). The SDC was 6.8 in PSPs and 5.9 in SSPs. Criterion responsiveness revealed poor areas under the curve for SSPs (0.58 to 0.64), and construct responsiveness was poor for PSPs (43% correctly predicted hypothesis). A floor effect of 26.5% was found in PSPs, with a change of 4 points representing the MIC., Conclusion: The modified Danish 8-item NDI was unidimensional, had construct validity, and was reproducible with a large but acceptable measurement error. However, responsiveness was poor and a significant floor effect was found in PSPs. A change score representing the MIC is proposed for PSPs., (© 2016 World Institute of Pain.)

Objective: Standard imaging techniques have low predictive value for identifying sources of neck pain. Single-photon emission computed tomography (SPECT) imaging in conjunction with computed tomography (CT) provides the sensitivity of bone scanning for areas of high metabolic activity with the sensitivity of CT for anatomic localization. We evaluated the usefulness of SPECT-CT imaging in identifying pain generators in upper cervical facet arthropathy., Methods: In a retrospective study, we reviewed 7 patients (mean age, 68.7 years) who underwent diagnostic SPECT-CT imaging for upper cervical neck pain at our institution from August 2011 to February 2015. We assessed SPECT-CT radiotracer uptake and postoperative neck disability index (NDI) and visual analog scale (VAS) scores., Results: Mean preoperative NDI and VAS scores were 42% (range, 34%-72%) and 7/10 (range, 5-8), respectively. SPECT-CT showed increased radiotracer uptake and inflammation at the level of pain generation indicated by history and physical examination. Intraoperatively, all patients had corresponding facet hypertrophy with degeneration at the site of increased radiotracer uptake. The mean postoperative NDI and VAS scores at 9 months were 23% (0%-54%) and 2/10 (0-5), respectively, representing improvements of 20% (P = 0.025) and 4 (P = 0.0028), respectively., Conclusions: SPECT-CT imaging of the upper cervical spine is a potentially sensitive diagnostic test that can implicate pain generators with increased metabolic activity. We propose that SPECT-CT may be a useful adjunct in the workup for neck pain secondary to facet arthropathy that could obviate diagnostic injections., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Unlabelled: Purpose The neck disability index (NDI) as a 10-item patient reported outcome (PRO) measure is the most commonly used whiplash associated disorders (WAD) assessment tool. However, statistical rigor and factor structure are not definitive. To date, confirmatory factor analysis (CFA) has not examined whether the factor structure generalizes across different groups (e.g., WAD versus non-WAD). This study aimed to determine the psychometric properties of the NDI in these population groups., Methods: This study used CFA to analyze NDI baseline-data for WAD (n = 804; 69 % females) and non-WAD (n = 963; 67 % females), each for the full sample and separate genders. Invariance analyses examined the NDI structure across the four groups., Results: Across both populations and gender subgroups the one-factor solutions consistently showed better model fit over two-factor solutions. The NDI was best characterized as one-dimensional and invariant across multiple sub-groups., Conclusion: The NDI remains a valid PRO in WAD populations that provides acceptable measurement of neck status that is appropriate for basic functional assessment across genders. However, it is recommended that both clinicians and researchers initiate the transition toward more rigorous and less ambiguous PRO measurement tools for WAD patients and research. This future graduated movement toward other PROs should consider both regional PROs and computerized decision support systems, initially measured concurrently with the NDI to establish ways to convert existing scored data prior to their singular use.

Purpose: Chronic whiplash-associated disorders (WAD) incur both costs and suffering. Treatments that can relieve chronic WAD are therefore needed. Exercise therapy (ET) has been shown to provide pain relief. Another often used treatment for chronic pain in Scandinavia is basic body awareness therapy (BAT). We compared the effectiveness of 10 weeks of twice-weekly, 90-min sessions of either ET or BAT in a randomized comparative trial., Method: We recruited 113 patients suffering from chronic WAD grades I-III and several years' duration of symptoms in a primary health care setting. 57 were allocated to ET and 56 to BAT. Primary outcome measures were Neck Disability Index and SF-36 v.2., Results: From baseline to post-treatment, the BAT group increased their physical functioning (median 5, IQR = 15) more than the ET group (median = 0, IQR = 15), p = 0.032, effect size -0.54. Three months after the end of treatment, the BAT group had less bodily pain (m = 17.5, 95% CI 6.9-17.6) than the ET group (m = 4.9, 95% CI -0.1 to 9.8), p = 0.044, effect size -0.4. The BAT group had also increased their social functioning (m = 13.3, 95% CI 6.6-19.9) more than the ET group (m = 3.5, 95% CI -3 to 9.9), p = 0.037, effect size -0.41. No statistically significant differences between groups were found for the change of other outcomes. No serious adverse effects were found in either groups., Conclusions: The present trial indicates that BAT led to greater improvements than ET for the patients with chronic WAD. IMPLICATIONS FOR REHABILATION: Chronic whiplash-associated disorders are disabling and incur great costs to society often through inability to work. Exercise therapy (ET) may alleviate symptoms of chronic WAD. Basic body awareness therapy (BAT) is often a component of multimodal pain rehabilitation programs. In this randomized comparative trial, BAT increased physical functioning and led to greater pain reduction and social functioning 3 months after the end of treatment.

Objective: This study was planned to compare of pain, emotional status and disability level in patients with chronic neck pain and low back pain., Methods: In this study, fifty patients with chronic low back pain (Group I) and fifty patients with chronic neck pain (Group II) at least 6 months were evaluated. A Visual Analog Scale was used to describe pain intensity. To determine emotional status of the subjects, the Beck Depression Scale was used The Oswestry Disability Index and the Neck Disability Index were used to evaluate disability level., Results: The mean age of the patients with low back pain and neck pain were 39.70 ± 9.71 years, 45.44 ± 10.39 years, respectively. It was not found a significant difference between in low back pain (Group I) and neck pain (Group II) in results of pain intensity (p= 0.286) and pain duration (p= 0.382). It was found a significant difference between group I and group II in results of emotional status (p= 0.000) and disability level (p= 0.000). The emotional status and disability level scores were found highest in patient's with low back pain., Conclusion: Chronic low back pain is affect in patients than chronic neck pain as a emotional status and disability level.

Object: The Neck Disability Index (NDI) and numeric rating scales (0 to 10) for neck pain and arm pain are widely used cervical spine disease-specific measures. Recent studies have shown that there is a strong relationship between the SF-6D and the NDI such that using a simple linear regression allows for the estimation of an SF-6D value from the NDI alone. Due to ease of administration and scoring, the EQ-5D is increasingly being used as a measure of utility in the clinical setting. The purpose of this study is to determine if the EQ-5D values can be estimated from commonly available cervical spine disease-specific health-related quality of life measures, much like the SF-6D., Methods: The EQ-5D, NDI, neck pain score, and arm pain score were prospectively collected in 3732 patients who presented to the authors' clinic with degenerative cervical spine disorders. Correlation coefficients for paired observations from multiple time points between the NDI, neck pain and arm pain scores, and EQ-5D were determined. Regression models were built to estimate the EQ-5D values from the NDI, neck pain, and arm pain scores., Results: The mean age of the 3732 patients was 53.3 ± 12.2 years, and 43% were male. Correlations between the EQ-5D and the NDI, neck pain score, and arm pain score were statistically significant (p < 0.0001), with correlation coefficients of -0.77, -0.62, and -0.50, respectively. The regression equation 0.98947 + (-0.00705 × NDI) + (-0.00875 × arm pain score) + (-0.00877 × neck pain score) to predict EQ-5D had an R-square of 0.62 and a root mean square error (RMSE) of 0.146. The model using NDI alone had an R-square of 0.59 and a RMSE of 0.150. The model using the individual NDI items had an R-square of 0.46 and an RMSE of 0.172. The correlation coefficient between the observed and estimated EQ-5D scores was 0.79. There was no statistically significant difference between the actual EQ-5D score (0.603 ± 0.235) and the estimated EQ-5D score (0.603 ± 0.185) using the NDI, neck pain score, and arm pain score regression model. However, rounding off the coefficients to fewer than 5 decimal places produced less accurate results., Conclusions: The regression model estimating the EQ-5D from the NDI, neck pain score, and arm pain score accounted for 60% of the variability of the EQ-5D with a relatively large RMSE. This regression model may not be sufficient to accurately or reliably estimate actual EQ-5D values.

Background: Migraine and neck pain can be critical causes of disability. The contribution of neck pain for the overall disability of individuals with migraine remains unknown., Objective: To contrast the disability experienced by individuals with episodic and chronic migraine with and without neck pain as captured by the Neck Disability Index., Methods: Disability due to neck pain was assessed using the Neck Disability Index in individuals with episodic or chronic migraine seen at a university-based headache center. Neck disability was defined as mild (score ranging from 5 to 14 points), moderate (15-24 points), severe (25-34 points) or complete (35 points or higher). To compare differences between groups, a chi-square test was applied. Log-binomial logistic regression was used to estimate disability as a function of headache status after adjustments for age, time since migraine onset, and headache intensity., Results: Sample consisted of 169 individuals, 104 with episodic migraine and 65 with chronic migraine. Any disability due to neck pain happened in 69% of those with episodic migraine, relative to 92% in chronic migraine (P < .001). Individuals with chronic migraine were at a significantly increased risk to have mild (RR = 2.5; CI 95% 1.1-6.1), moderate (RR = 3.7; CI 95% 1.5-8.8) and severe (RR = 5.1; CI 95%2.1-11.9) cervical disability relative to those with episodic migraine. Relative risks remained significant after adjustments. Time since episodic or chronic migraine onset significantly influenced the model (P = .035), but age and headache intensity did not (P = .27; P = .46)., Conclusion: Neck pain significantly adds to the overall disability of individuals with episodic and chronic migraine., (© 2014 American Headache Society.)

Objective: To investigate the short-term trajectory of recovery from mechanical neck pain, and predictors of trajectory., Design: Prospective, longitudinal cohort study with 5 repeated measurements over 4 weeks., Setting: Community-based physical therapy clinics., Participants: Convenience sample of community-dwelling adults (N=50) with uncomplicated mechanical neck disorders of any duration., Interventions: Usual physical therapy care., Main Outcome Measures: Neck Disability Index (NDI), numeric rating scale (NRS) of pain intensity., Results: A total of 50 consecutive subjects provided 5 data points over 4 weeks. Exploratory modeling using latent class growth analysis revealed a linear trend in improvement, at a mean of 1.5 NDI points and 0.5 NRS points per week. Within the NDI trajectory, 3 latent classes were identified, each with a unique trend: worsening (14.5%), rapid improvement (19.6%), and slow improvement (65.8%). Within the NRS trajectory, 2 unique trends were identified: stable (48.0%) and improving (52.0%). Predictors of trajectory class suggest that it may be possible to predict the trajectory. Results are described in view of the sample size., Conclusions: The mean trajectory of improvement in neck pain adequately fits a linear model and suggests slow but stable improvement over the short term. However, up to 3 different trajectories have been identified that suggest neck pain, and recovery thereof, is not homogenous. This may hold value for the design of clinical trials., (Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To investigate sensory and sensorimotor function in violin and viola players with and without neck pain., Design: Prospective, cross-sectional study., Setting: University laboratory., Participants: Convenience sample of violin players with playing-related neck pain (n=22), violinists without neck pain (n=21), and healthy nonmusician comparison subjects (n=21)., Interventions: Not applicable., Main Outcome Measures: Measures include thermal pain thresholds (cold and heat) and pressure pain thresholds (PPTs) over the cervical spine and over a remote region (tibialis anterior muscle). Motor performance tests including reaction times, speed of movement, accuracy, coordination, and tapping speed assessed with a special upper-limb test battery., Results: Musicians with neck pain had significantly lower heat and elevated cold pain thresholds as well as lower PPTs over C5-6 (P<.01) and over the tibialis anterior (P<.05). Motor performance tests revealed no differences between the symptomatic and asymptomatic musicians and nonmusician comparison groups (P>.05)., Conclusions: Violin players with neck pain demonstrated signs of sensory impairment, suggesting that playing-related neck pain may be associated with augmented central pain processing consistent with findings in other neck pain groups. No differences were evident in the motor performance tests. Fine motor skills of violin players may be better assessed in the context of playing their musical instruments before definitive conclusions can be drawn about the presence or not of sensorimotor impairments in this group of musicians with playing-related neck pain., (Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To establish an appropriate scoring system using Rasch scores for the strategic, tactical, and operational levels of the Neck Pain Driving Index (NPDI) and to refine the NPDI by testing the unidimensionality of each driving performance level using Rasch analysis., Design: Cross-sectional., Setting: Tertiary institution., Participants: Individuals with chronic whiplash-associated disorders (WAD) (N=123)., Interventions: Not applicable., Main Outcome Measure: The NPDI, which was developed to evaluate self-reported driving difficulty in people with chronic WAD., Results: On the basis of Rasch analyses, modifications were made to the response format, changing it from a 0 to 4 scale (0=no difficulty, 1=slight difficulty, 2=moderate difficulty, 3=great difficulty, 4=unable to drive because of the injury) to a 0 to 3 scale (0=no difficulty, 1=slight difficulty, 2=moderate difficulty, 3=great difficulty and unable to drive because of the injury). Unidimensionality of the strategic and operational levels was confirmed. Modification of the tactical level was necessary to ensure its unidimensionality. After removing the tasks "driving near (your) collision site," "driving in a bad weather condition," and "driving at night," unidimensionality of the 4-item tactical level was confirmed. A 9-item NPDI was established. A table converting raw total scores into Rasch scores was created for each level., Conclusions: This study established the 9-item NPDI, and its 3 subsections (strategic, tactical, and operational levels) are unidimensional. The magnitude of self-reported driving difficulty at each of the 3 subsections can be assessed with the use of a 0 to 3 scale and Rasch scores., (Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Background To ensure the validity and therapeutic utility of the Neck disability index (NDI) scale, translations, cultural adaptations and psychometric evidence is necessary. This study aimed to address the absence of a suitable and validated Hindi version of the NDI for the rural population. The specific objectives were to translate, adapt, and evaluate the psychometric properties of the newly developed Hindi version of the NDI. Methods Following guidelines provided by the American Association of Orthopedic Surgeons, the original English NDI scale was cross-culturally adapted into Hindi. The adaptation process included translations (forward and backward), expert committee review, pre-testing and cognitive debriefing with 30 individuals experiencing chronic non-specific neck pain. The outcome of this process was the creation of the Hindi version of the NDI, termed NDI-Hi. Subsequently, NDI-Hi was administered to 211 participants with neck pain from multiple centers for psychometric testing. The evaluation involved test-retest reliability over a 48-hour interval, factor analysis, assessment of internal reliability measures, and criterion-related validity by comparing it with the NPAD-Hindi version. Results The NDI-Hi version exhibited favorable psychometric properties, including good test-retest reliability with an intra-class correlation coefficient (ICC) of 0.87. Internal consistency of the scale was high, indicated by Cronbach’s alpha coefficient (α) of 0.96. The standard error of measurement (SEM) was determined to be 2.58, and the minimal detectable change (MDC) was calculated to be 7.15. Furthermore, the NDI-Hi showed significant correlation with the NPAD-Hindi version, with a correlation coefficient (rho) of 0.86, and a p-value of less than 0.001. Conclusions The NDI-Hi demonstrated validity and reliability as an outcome tool for assessing neck disability. It can be effectively utilized in clinical practice and research settings involving Hindi-speaking individuals with chronic non-specific neck pain. The adapted scale is particularly well-suited for the rural Northern Indian Hindi-speaking population.

Chronic non-specific neck pain (CNNP) poses a substantial health and economic burden in China. This study introduces a gamified motion-sensing health application framework to address the limitations of existing health applications. The gamified cervical spine somatic exercise application employs motion capture technology alongside the smartphone's built-in sensors to simulate accurate somatic interactions. Controlled experiments and data analyses demonstrated that the application significantly outperformed traditional text and video interventions in relieving participants' neck pain by increasing their average daily activity and compliance with the cervical spine exercise routine. The neck pain level of the participants is quantified by the Neck Disability Index (NDI). The results from the controlled experiments demonstrate that this gamified approach significantly decreases the Neck Disability Index (NDI) score from 1.54 to 1.24, highlighting its ability to alleviate neck pain and increase user compliance. [ABSTRACT FROM AUTHOR]

To investigate whether a combination of dry-needling treatments and upper extremity neuromuscular reeducation exercises can significantly improve neck pain and/or headache-related disability, joint position error, cervical range of motion, and pain pressure threshold in individuals suffering from cervicogenic headache (CGH). This study is a quasi-experimental design. Seven participants met the inclusion criteria and received dry needling to three muscles that reproduced the participant's headache symptoms and completed the Neck Disability Index (NDI), Headache Disability Inventory (HDI), Visual Analog Scale (VAS), and Numeric Pain Rating Scale (NPRS). Participants performed an exercise regimen designed to address strength and mobility of cervical and scapulothoracic musculature. There were significant improvements seen in cervical range of motion and neck pain-related disability (NDI) during the 4-week treatment period. Dry needling and neuromuscular re-education (NMR) exercises could be effective components of treatment for individuals suffering from CGH to reduce disability and pain. [ABSTRACT FROM AUTHOR]

Background To ensure the validity and therapeutic utility of the Neck disability index (NDI) scale, translations, cultural adaptations and psychometric evidence is necessary. This study aimed to address the absence of a suitable and validated Hindi version of the NDI for the rural population. The specific objectives were to translate, adapt, and evaluate the psychometric properties of the newly developed Hindi version of the NDI. Methods Following guidelines provided by the American Association of Orthopedic Surgeons, the original English NDI scale was cross-culturally adapted into Hindi. The adaptation process included translations (forward and backward), expert committee review, pre-testing and cognitive debriefing with 30 individuals experiencing chronic non-specific neck pain. The outcome of this process was the creation of the Hindi version of the NDI, termed NDI-Hi. Subsequently, NDI-Hi was administered to 211 participants with neck pain from multiple centers for psychometric testing. The evaluation involved test-retest reliability over a 48-hour interval, factor analysis, assessment of internal reliability measures, and criterion-related validity by comparing it with the NPAD-Hindi version. Results The NDI-Hi version exhibited favorable psychometric properties, including good test-retest reliability with an intra-class correlation coefficient (ICC) of 0.87. Internal consistency of the scale was high, indicated by Cronbach’s alpha coefficient (α) of 0.96. The standard error of measurement (SEM) was determined to be 2.58, and the minimal detectable change (MDC) was calculated to be 7.15. Furthermore, the NDI-Hi showed significant correlation with the NPAD-Hindi version, with a correlation coefficient (rho) of 0.86, and a p-value of less than 0.001. Conclusions The NDI-Hi demonstrated validity and reliability as an outcome tool for assessing neck disability. It can be effectively utilized in clinical practice and research settings involving Hindi-speaking individuals with chronic non-specific neck pain. The adapted scale is particularly well-suited for the rural Northern Indian Hindi-speaking population.

Background & Objective: Cervical traction and neural mobilization are frequently utilized in the management of cervical radiculopathy. However, there is a paucity of literature concerning the best order of application of these techniques. The aim of this study was to compare the effects of simultaneous and consecutive administration of cervical traction and neural mobilization on pain and function in cervical radiculopathy. Methods: Thirty patients were randomly assigned to two equal groups: consecutive (CON) and simultaneous (SIM) cervical traction and neural mobilization in this single-blind randomized controlled trial. The inclusion criteria comprised age 20-60 years, unilateral cervical radiculopathy ≥ 6 months, and positive upper limb neural tension tests of radial, median or ulnar nerve, and positive Spurling test. Outcome measurement tools were numeric pain rating scale, cervical goniometry, neck disability index, and short-form health survey. Data was analyzed with SPSS 23. Results: Significant improvement was evident in all parameters in CON after 1-week rehabilitation (P≤0.001 for seven of the ten variables). Similarly, all parameters showed significant improvement in SIM (P≤0.001 for all variables except mental component score of SF-12 with P<0.05). After rehabilitation, SIM was significantly better with respect to pain (P<0.05), flexion-extension mobility (P<0.001), and quality of life (P<0.01). No differences were found in other variables. Conclusion: Simultaneous use of cervical traction and neural mobilization resulted in significantly better outcomes with regards to pain, flexion-extension mobility, and quality of life. The two groups performed similarly on other outcome measures. [ABSTRACT FROM AUTHOR]

Background Osteoarthrosis of the lateral atlanto-axial joint (LAAJ) may be a cause of upper neck pain and headache. Intra-articular injection of steroids may provide only short-lasting relief. For intractable pain, arthrodesis of the joint might be considered. Objective To determine the success rates of arthrodesis of the lateral atlanto-axial joint for relieving neck pain and disability. Design Practice audit. Setting Private practice of senior author. Subjects Prospective series of 23 consecutive patients. Methods Outcomes were measured using a numerical rating scale for neck pain, and the Neck Disability Index for disability. Success rates were calculated for various degrees of improvement of neck pain at long-term follow-up (8–40 months), and for achieving various combinations of improvement of both neck pain and disability. Results Complete relief of pain was achieved in 40% of patients, with a further 40% achieving at least 50% relief. At long-term follow-up, 30% of patients had no neck pain and no disability, and a further 25% had only minimal pain, minimal disability, or both. Conclusions The present study did not corroborate earlier studies that claimed outstanding outcomes for arthrodesis of the LAAJ, but its outcomes are consonant with more recent studies that provided transparent outcome data. These studies provide Pain Physicians with empirical data on success rates and outcomes, upon which they can base their consideration of referral for arthrodesis. [ABSTRACT FROM AUTHOR]

To investigate if the responses to the Neck Disability Index (NDI) may produce some differential item functioning (DIF) comparing men and women. Register-based study among patients undergoing cervical surgery. Item response theory (IRT) analysis including a model for detecting a DIF. Of 338 patients, 171 (51%) were women and 167 (49%) were men. The mean age was 54.0 years. For most of the items, the average level of disability in a studied sample was associated with the middle point of the scale. The ability to distinguish people with different levels of disability was high or perfect for seven out of 10 items. While the DIF could be seen for all 10 items, only three items demonstrated statistically significant DIF – "pain intensity", "headaches" and "recreation". While the other seven items did not show statistically significant DIFs, better discrimination (steeper curves) for women could be graphically observed for "personal care", "lifting", "work", "driving" and "sleeping". It seemed that the NDI may behave differently depending on the sex of respondents. Several items of the NDI may be more precise and more sensitive when detecting restrictions in functioning among women compared to men. This finding should be taken into account when using the NDI in research and clinical practice. While the Neck Disability Index have been found to be a reliable and valid scale, potential differences in its properties across different sexes have mostly remained uninvestigated. This study showed that the Neck Disability Index may behave differently depending on the sex of respondents. Several items of the Neck Disability Index were more precise and sensitive when detecting restrictions in functioning among women compared to men. This difference should be taken into account when using the NDI in research and clinical practice. [ABSTRACT FROM AUTHOR]

Study Design. Translation and psychometric testing. Objectives. To cross-culturally adapt the Neck Disability Index (NDI) into the Hindi language, the local language of India, and to investigate the psychometric properties of the Neck Disability Index-Hindi (NDI-H) version in patients with neck pain. Summary of Background Data. The NDI is the most used selfreported outcome measure for neck pain. The previous NDI-H version did not obtain advance permission from Mapi trust to translate this scale. As a result, this scale's availability is limited. Materials and Methods. Following established guidelines, the NDI was translated and culturally adapted into Hindi. A total of 120 chronic neck pain patients (20 for cognitive interviews and 100 for psychometric testing) participated in this study. The content validity, construct validity, internal consistency, test-retest reliability, and responsiveness of the NDI-H were all evaluated. The intraclass correlation coefficient was computed to determine test-retest reliability. Internal consistency was assessed using Cronbach α. The NDI's factor structure was investigated using principal component factor analysis. The Neck Pain and Disability Scale, Numeric Pain Rating Scale, and Anxiety and Depression scales were used to test criterion validity. The receiver operating characteristic curve analysis was used to determine the cut-off point and the area under the curve. Results. The NDI-H demonstrated good test-retest reliability (intraclass correlation coefficient = 0.92) and excellent internal consistency (Cronbach α = 0.90). The one-factor structure was revealed by the factor analysis. The NDI has a strong relationship with the Neck Pain and Disability Scale and Numeric Pain Rating Scale, as well as the Anxiety and Depression scales. The cut-point for detecting a change was 9.3. Conclusions. The NDI was successfully translated into Hindi in this study. The NDI-H is a reliable and valid and responsive instrument that can be used to treat patients with chronic neck pain in clinical and research settings. [ABSTRACT FROM AUTHOR]

While cervical disc replacement (CDR) has been emerging as a reliable and efficacious treatment option for degenerative cervical spine pathology, not all patients undergoing CDR will achieve minimal clinically important difference (MCID) in patient-reported outcome measures (PROMs) postoperatively—risk factors for failure to achieve MCID in PROMs following CDR have not been established. To identify risk factors for failure to achieve MCID in Neck Disability Index (NDI, Visual Analog Scale (VAS) neck and arm following primary 1- or 2-level CDRs in the early and late postoperative periods. Retrospective review of prospectively collected data. Patients who had undergone primary 1- or 2-level CDR for the treatment of degenerative cervical pathology at a single institution with a minimum follow-up of 6 weeks between 2017 and 2022. Patient-reported outcomes: Neck disability index (NDI), Visual analog scale (VAS) neck and arm, MCID. Minimal clinically important difference achievement rates for NDI, VAS-Neck, and VAS-Arm within early (within 3 months) and late (6 months to 2 years) postoperative periods were assessed based on previously established thresholds. Multivariate logistic regressions were performed for each PROM and evaluation period, with failure to achieve MCID assigned as the outcome variable, to establish models to identify risk factors for failure to achieve MCID and predictors for achievement of MCID. Predictor variables included in the analyses featured demographics, comorbidities, diagnoses/symptoms, and perioperative characteristics. A total of 154 patients met the inclusion criteria. The majority of patients achieved MCID for NDI, VAS-Neck, and VAS-Arm for both early and late postoperative periods—79% achieved MCID for at least one of the PROMs in the early postoperative period, while 80% achieved MCID for at least one of the PROMs in the late postoperative period. Predominant neck pain was identified as a risk factor for failure to achieve MCID for NDI in the early (OR: 3.13 [1.10–8.87], p-value:.032) and late (OR: 5.01 [1.31–19.12], p-value:.018) postoperative periods, and VAS-Arm for the late postoperative period (OR: 36.63 [3.78–354.56], p-value:.002). Myelopathy was identified as a risk factor for failure to achieve MCID for VAS-Neck in the early postoperative period (OR: 3.40 [1.08–10.66], p-value:.036). Anxiety was identified as a risk factor for failure to achieve MCID for VAS-Neck in the late postoperative period (OR: 6.51 [1.91–22.18], p-value:.003). CDR at levels C5C7 was identified as a risk factor for failure to achieve MCID in NDI for the late postoperative period (OR: 9.74 [1.43–66.34], p-value:.020). Our study identified several risk factors for failure to achieve MCID in common PROMs following CDR including predominant neck pain, myelopathy, anxiety, and CDR at levels C5−C7. These findings may help inform the approach to counseling patients on outcomes of CDR as the evidence suggests that those with the risk factors above may not improve as reliably after CDR. [ABSTRACT FROM AUTHOR]

Neck Pain (NP) and low back pain (LBP) are ubiquitous musculoskeletal conditions and some of the major causes of disability worldwide. The aim of the study was to assess the incidence and risk factors of back pain among paramedics and their correlation with the nature of work, anthropometric features and the level of recreational physical activity. A group of 201 individuals (39 females (19.40%); 162 males (80.60%)), licensed to practice as paramedics in Poland completed a questionnaire containing the author's interview as well as the Neck Disability Index (NDI) questionnaire and the Revised Oswestry Disability Index (ODI). Among the examined paramedics, 92% of the subjects reported the presence of back pain in different parts of the spine (36% C; 17% Th; and 85% LBP). The pain intensity, determined by VAS, was on average 4.26 (SD 1.77). The level of disability, assessed by NDI, was 7.67 (SD 5.73) on average, while the ODI was 7.51 (5.90). Work-related spinal strain has a major impact on the intensity and incidence of spinal pain. Spinal pain in paramedics mainly occurs in the lower back. [ABSTRACT FROM AUTHOR]

Neck pain that is not specific to any cause is a common issue among the general population, with a prevalence ranging from 10% to 15%. There is a strong association between trapezius muscle spasm and non-specific neck pain. [Aim] To compare the effect of two therapeutic approaches, namely Myofascial Release (MFR) and Art Therapy, addressing upper trapezius spasm for patients suffering from nonspecific neck pain. [After approval of the Institutional Ethics Committee. (I.E.C) patients between the age group of 20-50 years having non-specific neck pain were selected based on inclusion and exclusion criteria. Three outcome measures were taken, VAS for pain assessment Cervical ROM and NDI for functional performance in routine activities. Materials and Methods: The study was done over a sample size of 30 patients which included both male and female patients among the age group of 20 - 50 years suffering from non-specific neck pain. They were divided in two groups where Group A(n-15) received ART and Group B (n-15) received MFR. Randomized sampling was used for selecting the sample population. Duration of study was 12 weeks. Results: Paired and unpaired sample t-test were used to compare the outcome differences between each group. Improvement was significant in both the groups but Group A who received ART had a higher efficacy and effectiveness with VAS (P<0.003), cervical ROM (P<0.004), NDI (P<0.002) as compared to Group B in terms of pain, and range of motion and functional ability. Conclusion, although both the techniques are effective in improving the symptoms of non-specific neck pain, active release therapy had higher effectiveness. [ABSTRACT FROM AUTHOR]

Chronic neck pain is a leading health issue affecting a significant proportion of the global population. Multiple treatment options for chronic neck pain include anti-inflammatory drugs and analgesics. Acupuncture has been widely used for the treatment of chronic pain. In this study, we aimed to determine the efficacy of acupuncture for female patients with chronic neck pain. Twenty-three participants were enrolled in the study, and participants waited 4 weeks without acupuncture treatment and then received 4 weeks of treatment. One-way ANOVA with repeated measures was used to determine differences in the visual analogue scale (VAS), neck disability index (NDI), and substance P (SP) over time. The subjects' pain intensity and degree of disability due to neck pain were measured as primary outcomes. SP in the blood was also analyzed as a secondary outcome. There was no significant difference between the VAS score and NDI value of baseline and after 4 weeks waiting. However, there was an improvement in both VAS and NDI after 4 weeks treatment. SP level was decreased after 4 weeks treatment. We could conclude that acupuncture is effective in alleviating chronic neck pain. Moreover, our findings revealed the efficacy of acupuncture on chronic pain with potential underlying biological mechanisms. [ABSTRACT FROM AUTHOR]

IntroductionMechanical neck pain has become prevalent among computer professionals possibly because of prolonged computer use. This study aimed to investigate the relationship between neck pain intensity, anthropometric metrics, cervical range of motion, and related disabilities using advanced machine learning techniques.MethodThis study involved 75 computer professionals, comprising 27 men and 48 women, aged between 25 and 44 years, all of whom reported neck pain following extended computer sessions. The study utilized various tools, including the visual analog scale (VAS) for pain measurement, anthropometric tools for body metrics, a Universal Goniometer for cervical ROM, and the Neck Disability Index (NDI). For data analysis, the study employed SPSS (v16.0) for basic statistics and a suite of machine-learning algorithms to discern feature importance. The capability of the kNN algorithm is evaluated using its confusion matrix.ResultsThe “NDI Score (%)” consistently emerged as the most significant feature across various algorithms, while metrics like age and computer usage hours varied in their rankings. Anthropometric results, such as BMI and body circumference, did not maintain consistent ranks across algorithms. The confusion matrix notably demonstrated its classification process for different VAS scores (mild, moderate, and severe). The findings indicated that 56% of the pain intensity, as measured by the VAS, could be accurately predicted by the dataset.DiscussionMachine learning clarifies the system dynamics of neck pain among computer professionals and highlights the need for different algorithms to gain a comprehensive understanding. Such insights pave the way for creating tailored ergonomic solutions and health campaigns for this population.

Abstract Background Neck pain and headache are highly prevalent conditions and leading causes of disability worldwide. Although MRI is widely used in the management of these conditions, there is uncertainty about the clinical significance of cervical MRI findings in patients with neck pain or headache. Therefore, this study aims to investigate the association between cervical degenerative MRI findings and self-reported neck pain, neck disability, and headache. Methods This study was a secondary analysis of a cohort of patients with low back pain aged 18–40 years recruited from a non-surgical outpatient spine clinic. The cervical MRI and outcome measures used in this analysis were collected at a four-year follow-up (2014–2017). Self-reported outcome measures included neck pain intensity, neck disability as measured by the Neck Disability Index, and headache as measured by a single NDI item. Cervical MRI findings included disc degeneration, disc contour changes, and vertebral endplate signal changes (VESC). Multivariable logistic regression analyses, adjusted for age and sex, were used to analyse the associations between MRI findings and neck pain, neck disability, and headache. Results A total of 600 participants who underwent MRI and completed the relevant questionnaires at follow-up were included. The median age was 37 years (interquartile range 31–41) and 325 (54%) were female. Of the included participants, 181 (31%) had moderate or severe neck pain, 274 (59%) had moderate or severe neck disability, 193 (42%) reported headaches, and 211 (35%) had one or more cervical degenerative MRI findings. Cervical disc degeneration and disc contour changes were positively associated with moderate or severe neck pain with odds ratio 1.6 (95% CI 1.1–2.4) and 1.6 (1.1–2.3), respectively. VESC was associated with moderate or severe neck disability with odds ratio 3.3 (1.3–8.4). No statistically significant associations were found between the MRI findings assessed and headache. Conclusions In this cross-sectional exploratory study, we found that cervical disc degeneration and disc contour changes were associated with neck pain, and VESC was associated with neck disability. None of the MRI findings were associated with headache. The results suggest that cervical degenerative changes may contribute to the aetiology of neck symptoms, but the associations are modest and cannot guide clinical decisions.

Background: Neck pain and headache are highly prevalent conditions and leading causes of disability worldwide. Although MRI is widely used in the management of these conditions, there is uncertainty about the clinical significance of cervical MRI findings in patients with neck pain or headache. Therefore, this study aims to investigate the association between cervical degenerative MRI findings and self-reported neck pain, neck disability, and headache. Methods: This study was a secondary analysis of a cohort of patients with low back pain aged 18–40 years recruited from a non-surgical outpatient spine clinic. The cervical MRI and outcome measures used in this analysis were collected at a four-year follow-up (2014–2017). Self-reported outcome measures included neck pain intensity, neck disability as measured by the Neck Disability Index, and headache as measured by a single NDI item. Cervical MRI findings included disc degeneration, disc contour changes, and vertebral endplate signal changes (VESC). Multivariable logistic regression analyses, adjusted for age and sex, were used to analyse the associations between MRI findings and neck pain, neck disability, and headache. Results: A total of 600 participants who underwent MRI and completed the relevant questionnaires at follow-up were included. The median age was 37 years (interquartile range 31–41) and 325 (54%) were female. Of the included participants, 181 (31%) had moderate or severe neck pain, 274 (59%) had moderate or severe neck disability, 193 (42%) reported headaches, and 211 (35%) had one or more cervical degenerative MRI findings. Cervical disc degeneration and disc contour changes were positively associated with moderate or severe neck pain with odds ratio 1.6 (95% CI 1.1–2.4) and 1.6 (1.1–2.3), respectively. VESC was associated with moderate or severe neck disability with odds ratio 3.3 (1.3–8.4). No statistically significant associations were found between the MRI findings assessed and headache. Conclusions: In this cross-sectional exploratory study, we found that cervical disc degeneration and disc contour changes were associated with neck pain, and VESC was associated with neck disability. None of the MRI findings were associated with headache. The results suggest that cervical degenerative changes may contribute to the aetiology of neck symptoms, but the associations are modest and cannot guide clinical decisions. [ABSTRACT FROM AUTHOR]

Study Design.: Retrospective cohort study. Objective.: The present study is the first to assess the impact of paraspinal sarcopenia on patient-reported outcome measures (PROMs) following cervical laminoplasty. Background.: While the impact of sarcopenia on PROMs following lumbar spine surgery is well-established, the impact of sarcopenia on PROMs following laminoplasty has not been investigated. Methods.: We performed a retrospective review of patients undergoing laminoplasty from C4-6 at a single institution between 2010 and 2021. Two independent reviewers utilized axial cuts of T2-weighted magnetic resonance imaging sequences to assess fatty infiltration of the bilateral transversospinales muscle group at the C5-6 level and classify patients according to the Fuchs Modification of the Goutalier grading system. PROMs were then compared between subgroups. Results.: We identified 114 patients for inclusion in this study, including 35 patients with mild sarcopenia, 49 patients with moderate sarcopenia, and 30 patients with severe sarcopenia. There were no differences in preoperative PROMs between subgroups. Mean postoperative neck disability index scores were lower in the mild and moderate sarcopenia subgroups (6.2 and 9.1, respectively) than in the severe sarcopenia subgroup (12.9, P =0.01). Patients with mild sarcopenia were nearly twice as likely to achieve minimal clinically important difference (88.6 vs. 53.5%; P <0.001) and six times as likely to achieve SCB (82.9 vs. 13.3%; P =0.006) compared with patients with severe sarcopenia. A higher percentage of patients with severe sarcopenia reported postoperative worsening of their neck disability index (13 patients, 43.3%; P =0.002) and Visual Analog Scale Arm scores (10 patients, 33.3%; P =0.03). Conclusion.: Patients with severe paraspinal sarcopenia demonstrate less improvement in neck disability and pain postoperatively and are more likely to report worsening PROMs following laminoplasty. Level of Evidence.: 3 [ABSTRACT FROM AUTHOR]

Abstract Background Health domains like pain, disability, and health-related quality of life are commonly used outcomes for musculoskeletal disorders. Most prognostic studies include only one outcome, and it is unknown if prognostic factors and models may be generic across different outcomes. The objectives of this study were to examine the correlation among commonly used outcomes for neck pain (pain intensity, disability, and health-related quality of life) and to explore how the predictive performance of a prognostic model differs across commonly used outcomes. Methods We conducted an observational prospective cohort study with data from patients with neck pain aged 18–84 years consulting Norwegian chiropractors. We used three different outcomes: pain intensity (Numeric Pain Rating Scale), the Neck Disability Index (NDI), and health-related quality of Life (EQ-5D). We assessed associations between change in outcome scores at 12-weeks follow-up with Pearson’s correlation coefficient. We used multivariable linear regression models to explore differences in explained variance and relationship between predictors and outcomes. Results The study sample included 1313 patients and 941 (72%) completed follow-up at 12 weeks. The strongest correlation was between NDI and EQ-5D (r = 0.57) while the weakest correlation was between EQ-5D and pain intensity (r = 0.39). The correlation between NDI and pain intensity was moderate (r = 0.53) In the final regression models, the explained variance ranged from adjusted R2 of 0.26 to 0.60, highest with NDI and lowest with pain intensity as outcome. The predictive contributions of the included predictors were similar across outcomes. Among the investigated predictors, pain patterns and the baseline measure of the corresponding outcome measure contributed the most to explained variance across all outcomes. Conclusions The highest correlation was found between NDI and EQ-5D and the lowest with pain intensity. The same prognostic model showed highest predictive performance with NDI as outcome and poorest with pain intensity as outcome. These results suggest that we need more knowledge on the reasons for the differences in predictive performance variation across outcomes.

Background. Migraine is one of the most important causes of disability worldwide and is a frequently accompanied by neck pain. The aim of this study was to evaluate the effect of upper cervical manual therapy (MT) on headache characteristics, central sensitization (CS) and disability in subjects with migraine and neck pain. Methods. 30 subjects with migraine and neck pain (30 female, mean age 43.10 ± 8.13) were randomly assigned to MT group (MTG), sham MT group (SMTG), and a control group (CG). Central sensitization inventory (CSI) score, disability indices including neck disability index (NDI) and Headache Impact Test (HIT-6), headache characteristics, and medication use were evaluated in all subjects pre and post inter- vention. Subjects in the MTG and SMTG received either 4 sessions of MT or sham MT. Subjects in the CG received medication only. Results. Subjects in the MTG had a significant reduction in headache characteristics, medication use, CSI score, and disability indices (p < 0.05). CSI score was positively correlated with headache days, headache duration, and NDI score (p < 0.05). Conclusions. Upper cervical MT have beneficial effects on headache symptoms, disability, and CSI score in subjects with migraine and neck pain. The result of this study suggests that MT may be a useful component in the multimodal management of migraine. Study registration. The trial design was registered in the Iranian Registry of Clinical Trial (IRCT ID: IRCT20160621028567N2, url: https://www.irct.ir/) before the first patient was enrolled. [ABSTRACT FROM AUTHOR]

Study Design: A retrospective observational study. Objective: To clarify the association of the paraspinal muscle area and composition with clinical features in patients with cervical ossification of the posterior longitudinal ligament (OPLL). Methods: Consecutive patients with cervical OPLL who underwent cervical magnetic resonance imaging (MRI) before surgery were reviewed. The cross-sectional area (CSA) and fatty infiltration ratio (FI%) of deep posterior cervical paraspinal muscles (multifidus [MF] and semispinalis cervicis [SCer]) were examined. We assessed the association of paraspinal muscle measurements with the clinical characteristics and clinical outcomes, such as Neck Disability Index (NDI) score. Moreover, we divided the patients into 2 groups according to the extent of the ossified lesion (segmental and localized [OPLL-SL] and continuous and mixed [OPLL-CM] groups) and compared these variables between the 2 groups. Results: 49 patients with cervical OPLL were enrolled in this study. The FI% of the paraspinal muscles was significantly associated with the number of vertebrae (ρ = 0.283, p = 0.049) or maximum occupancy ratio of OPLL (ρ = 0.397, p = 0.005). The comparative study results indicated that the NDI score was significantly worse (OPLL-SL, 22.9 ± 13.7 vs. OPLL-CM, 34.4 ± 13.7) and FI% of SCer higher (OPLL-SL, 9.1 ± 1.7% vs. OPLL-CM, 11.1 ± 3.7%) in the OPLL-CM group than those in the OPLL-SL group. Conclusions: Our results suggest that OPLL severity may be associated with fatty infiltration of deep posterior cervical paraspinal muscles, which could affect neck disability in patients with cervical OPLL. [ABSTRACT FROM AUTHOR]

Back ground: Chronic neck pain is one of the most common musculoskeletal pain conditions experienced by many people during their lives. Due to increased use of Tech devices & modern life style, forward head posture & resultant neck pain becomes quiet common. Although patients with neck pain are managed predominantly as musculoskeletal patients, there are indications that they also have poor pulmonary function as limited movement of the neck muscles can result in impaired chest movements. The aim of this study was to examine whether patients with chronic neck pain have impaired pulmonary measures. Methodology: A cross sectional observational study was conducted to evaluate pulmonary function measures in patients with chronic neck pain.100 subjects included dividing them into 2 groups. Group A: Patients with Chronic Neck Pain. Group B: Age & sex matched healthy individuals. Written Consent was taken from the subjects and the subjects were made to understand the purpose of the study. Spirometry was performed for all the subjects. Forced vital capacities (FVC), forced expiratory volume in the first second of FVC (FEV1), ratio of FEV1/FVC and maximum voluntary ventilation (MVV) were recorded. Neck Disability Index (NDI), Numeric Pain Rating Scale (NPRS) for pain & Craniocervical Angle (CCA) had also been considered for both the groups. Results: Data analysis was done using Microsoft office Excel. The results showed that patients with chronic neck pain yielded significantly reduced FVC, FEV1 and maximum voluntary ventilation (P < 0.005), but FEV1/FVC ratio were not affected significantly (P > 0.5). Craniocervical Angle & Pain Intensity was found to be significantly correlated with respiratory function. CONCLUSION: Patients with chronic neck pain do not have optimal pulmonary function. Cervical spine muscle dysfunction in parallel with pain intensity and kinesiophobia are factors that are associated mainly with this respiratory dysfunction. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the risk factors associated with upper crossed syndrome (UCS) in females of age 25-50 years. METHODS: This population based case controlled study was conducted from May to August 2019. Total of 210 females including 105 cases (participants who had upper neck pain for at least one month) and 105 controls (participants who didn't had upper neck pain), aging 25-50 years were selected through non-probability convenient sampling technique from the population of Gujrat, Punjab Pakistan. Data was collected through a pre-tested questionnaire and analyzed through SPSS software (version 21.0). Universal goniometer used to assess cervical ranges. Neck disability index (NDI) was used for functional disability and visual analog scale (VAS) was applied to assess the degree of pain. RESULTS: Majority (n=88; 41.90%) of females were in age group of 25-30 years and were housewives (n=147; 70 %). Females who used handheld devices, unsupported back chairs, read, worked, travelled for more than 3 hours had 63.91, 9.127, 3.568, 3.301, 2.068 folds risk of developing UCS respectively as compared to those who did the same for less than 3 hours. Similarly, females who were fetal sleeper had 2.032 times more risk of than front sleeper. All risk factors were statistically significant (p< 0.005). CONCLUSION: Usage of handheld devices while reading, working, and travelling for >3 hours, sleeping with curved spine and in fetal position and unsupported back chair increase the risk of UCS.

Study Design: Retrospective cohort study.Objective: The present study is the first to assess the impact of paraspinal sarcopenia on patient-reported outcome measures (PROMs) following posterior cervical decompression and fusion (PCDF).Summary Of Background Data: While the impact of sarcopenia on PROMs following lumbar spine surgery is well-established, the impact of sarcopenia on PROMs following PCDF has not been investigated.Materials and Methods: We performed a retrospective review of patients undergoing PCDF from C2 to T2 at a single institution between the years 2017 and 2020. Two independent reviewers who were blinded to the clinical outcome scores utilized axial cuts of T2-weighted magnetic resonance imaging sequences to assess fatty infiltration of the bilateral multifidus muscles at the C5-C6 level and classify patients according to the Fuchs Modification of the Goutalier grading system. PROMs were then compared between subgroups.Results: We identified 99 patients for inclusion in this study, including 28 patients with mild sarcopenia, 45 patients with moderate sarcopenia, and 26 patients with severe sarcopenia. There was no difference in any preoperative PROM between the subgroups. Mean postoperative Neck Disability Index scores were lower in the mild and moderate sarcopenia subgroups (12.8 and 13.4, respectively) than in the severe sarcopenia subgroup (21.0, P <0.001). A higher percentage of patients with severe multifidus sarcopenia reported postoperative worsening of their Neck Disability Index (10 patients, 38.5%; P =0.003), Visual Analog Scale Neck scores (7 patients, 26.9%; P =0.02), Patient-Reported Outcome Measurement Information System Physical Component Scores (10 patients, 38.5%; P =0.02), and Patient-Reported Outcome Measurement Information System Mental Component Scores (14 patients, 53.8%; P =0.02).Conclusion: Patients with more severe paraspinal sarcopenia demonstrate less improvement in neck disability and physical function postoperatively and are substantially more likely to report worsening PROMs postoperatively.Level Of Evidence: 3. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nonspecific neck pain is a common musculoskeletal disorder causing disability among the general population. Specific dynamic strength-endurance exercises may help maintain improved posture, which in turn can lessen or eliminate recurrent flare-ups of pain. The effect of exercise on patients with chronic nonspecific neck pain has been investigated in several studies. The efficacy is, however, questionable. AIM: The aim of the study is to find the effectiveness of dynamic strength-endurance training in reducing pain and improving function in nonspecific neck pain. DESIGN: This study was a pre- and postintervention design. SETTING: This study was conducted in tertiary care hospital in Mangaluru. MATERIALS AND METHODS: In this pre- and postexperimental study, dynamic strength-endurance training for cervical and scapular muscles was given to 24 adults fulfilling inclusion criteria for 4 weeks. The Neck Disability Index (NDI) was used for pain and disability assessment, and the Neck Bournemouth Questionnaire (NBQ) and the Northwick Park Neck Pain Questionnaire (NPNQ) were used for pain assessment. RESULTS: There was a significant reduction in NDI, NBQ, and NPNQ scores exceeding minimal clinically important difference (NDI >7.5 points, NBQ >5.5 points, and NPNQ >7.6 points) after 4 weeks of strength-endurance training of cervical and scapular muscles. There was significant improvement in hold time. Statistically, a significant difference was observed in pre- and posttreatment effect comparison of all outcome measures (P > 0.01). CONCLUSION: A dynamic strength-endurance training program is effective in reducing pain and disability in a patient with nonspecific neck pain. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the risk factors associated with upper crossed syndrome (UCS) in females of age 25-50 years. METHODS: This population based case controlled study was conducted from May to August 2019. Total of 210 females including 105 cases (participants who had upper neck pain for at least one month) and 105 controls (participants who didn't had upper neck pain), aging 25-50 years were selected through nonprobability convenient sampling technique from the population of Gujrat, Punjab Pakistan. Data was collected through a pre-tested questionnaire and analyzed through SPSS software (version 21.0). Universal goniometer used to assess cervical ranges. Neck disability index (NDI) was used for functional disability and visual analog scale (VAS) was applied to assess the degree of pain. RESULTS: Majority (n=88; 41.90%) of females were in age group of 25-30 years and were housewives (n=147; 70 %). Females who used handheld devices, unsupported back chairs, read, worked, travelled for more than 3 hours had 63.91, 9.127, 3.568, 3.301, 2.068 folds risk of developing UCS respectively as compared to those who did the same for less than 3 hours. Similarly, females who were fetal sleeper had 2.032 times more risk of than front sleeper. All risk factors were statistically significant (p< 0.005). CONCLUSION: Usage of handheld devices while reading, working, and travelling for >3 hours, sleeping with curved spine and in fetal position and unsupported back chair increase the risk of UCS. [ABSTRACT FROM AUTHOR]

Study Design: Cross-sectional, epidemiological study.Objective: This study aims to describe the prevalence, risk factors, disability, and quality of life (QoL) burden of neck pain.Summary Of Background Data: Neck pain is an increasingly common symptom that results in significant disability and loss of QoL to the individual, and imposes a considerable economic burden to developed countries.Methods: A cross-sectional, questionnaire-based study was conducted via multistage random sampling of public households in Singapore on individuals aged 21 and older. Questionnaires were administered face-to-face by trained interviewers. Data analyzed included the prevalence and characteristics of neck pain, its relationship with sociodemographic factors, and its association on QoL and disability via validated questionnaires: EQ5D questionnaire and Neck Disability Index (NDI), respectively.Results: A total of 626 individuals with a median age of 52.0 years (interquartile range 37.0-67.0), and even sex distribution of males (54.0%) and females (46.0%) were included in this study. A total of 144 individuals reported neck pain over the past 6 months, giving a 6-month period prevalence of 23.0%. Among them, nine (6.3%) had chronic, whereas 12 (8.3%) had severe neck pain. Female sex was the only significant risk factor for neck pain on multivariate analysis, with a risk ratio of 1.34 (95% confidence interval [CI] 1.00-1.80, P = 0.049). Individuals with neck pain had mean raw NDI scores of 4.91 ± 6.25, with higher disability seen with increasing pain duration and intensity (P < 0.001 and P = 0.002 respectively). Compared to individuals without neck pain, those with neck pain had poorer QoL with lower EQ5D-Index scores (0.84 ± 0.25 vs. 0.93 ± 0.15; 95% CI 0.046-0.132, P < 0.001) and EQ5D-VAS scores (68.76 ± 14.59 vs. 73.86 ± 13.64; 95% CI 2.510-7.697, P < 0.001).Conclusion: Our findings show that neck pain is a prevalent condition with chronicity and severity of symptoms associated with reduced QoL and increased disability. Population sample health scores can serve as potential reference targets in disease management and aid national health care policy-making.Level of Evidence: 3. [ABSTRACT FROM AUTHOR]

Stomatologists present a high risk of musculoskeletal symptoms at the level neck level. Stomatology-specific manoeuvres require high precision, which calls for a flexed and rotated posture of the cervical spine. This position of the cervical spine leads to a high static load in the neck region which through high duration and repetitive neck movement can generate painful symptomatology in the cervical region, accompanied by muscle disequilibrium or cervical instability. Neck pain has become a serious health issue, especially amongst stomatologists. The evaluation of the neck disability index provides information about the way in which neck pain affects the capacity of managing everyday life.