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      Predictors of outcome in neck pain patients undergoing chiropractic care: comparison of acute and chronic patients.

      Chiropractic & Manual Therapies

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          The prevalence of neck pain in the world population: a systematic critical review of the literature.

          The objective of this study was to determine the prevalence of neck pain (NP) in the world population and to identify areas of methodological variation between studies. A systematic search was conducted in five databases (MEDLINE, EMBASE, CINAHL, OSH-ROM, and PsycINFO), followed by a screening of reference lists of relevant papers. Included papers were extracted for information and each paper was given a quality score. Mean prevalence estimates were calculated for six prevalence periods (point, week, month, 6 months, year, and lifetime), and considered separately for age, gender, quality score, response rate, sample size, anatomical definition, geography, and publication year. Fifty-six papers were included. The six most commonly reported types of prevalence were point, week, month, 6 months, year, and lifetime. Except for lifetime prevalence, women reported more NP than men. For 1-year prevalence, Scandinavian countries reported more NP than the rest of Europe and Asia. Prevalence estimates were not affected by age, quality score, sample size, response rate, and different anatomical definitions of NP. NP is a common symptom in the population. As expected, the prevalence increases with longer prevalence periods and generally women have more NP than men. At least for 1-year prevalence Scandinavian countries report higher mean estimates than the rest of Europe and Asia. The quality of studies varies greatly but is not correlated with the prevalence estimates. Design varies considerably and standardisation is needed in future studies.
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            A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study.

            Conflicting evidence exists about the effectiveness of spinal manipulation. To validate a manipulation clinical prediction rule. Multicenter randomized, controlled trial. Physical therapy clinics. 131 consecutive patients with low back pain, 18 to 60 years of age, who were referred to physical therapy. Patients were randomly assigned to receive manipulation plus exercise or exercise alone by a physical therapist for 4 weeks. Patients were examined according to the clinical prediction rule criteria (symptom duration, symptom location, fear-avoidance beliefs, lumbar mobility, and hip rotation range of motion). Disability and pain at 1 and 4 weeks and 6 months were assessed. Outcome from spinal manipulation depends on a patient's status on the prediction rule. Treatment effects are greatest for the subgroup of patients who were positive on the rule (at least 4 of 5 criteria met); health care utilization among this subgroup was decreased at 6 months. Compared with patients who were negative on the rule and received exercise, the odds of a successful outcome among patients who were positive on the rule and received manipulation were 60.8 (95% CI, 5.2 to 704.7). The odds were 2.4 (CI, 0.83 to 6.9) among patients who were negative on the rule and received manipulation and 1.0 (CI, 0.28 to 3.6) among patients who were positive on the rule and received exercise. A patient who was positive on the rule and received manipulation has a 92% chance of a successful outcome, with an associated number needed to treat for benefit at 4 weeks of 1.9 (CI, 1.4 to 3.5). The response rate for the 6-month follow-up resulted in inadequate power to detect statistically significant differences for some comparisons. The spinal manipulation clinical prediction rule can be used to improve decision making for patients with low back pain.
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              A Welfare State Paradox: State Interventions and Women’s Employment Opportunities in 22 Countries

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                Author and article information

                Journal
                3574031
                10.1186/2045-709X-20-27
                22920497

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