Non-specific neck pain: to match or not to match?
pain is the fourth major cause of disability worldwide. Additionally, neck pain poses an important socio-economic burden on society because pain, stiffness or loss of mobility associated with neck pain often results in utilization of diagnostic assessments and treatments. The physiotherapist is expected to conduct an examination and subsequently provide an appropriate treatment. In order to maximize the effectiveness of physiotherapy interventions , the physiotherapist must base treatment on the best available evidence ( evidence based practice) to give the most effective treatment possible. Physiotherapists are qualified and professionally required to: • undertake a comprehensive examination/assessment of the patient/client or needs of a client group • evaluate the findings from the examination/assessment to make clinical judgments regarding patients/clients • formulate a diagnosis, prognosis within their expertise and determine when patients/ clients need to be referred to another professional • implement a physiotherapist intervention/treatment programme • determine the outcomes of any interventions/treatments • make recommendations for self-management The physiotherapist should make use of relevant questions during history taking. After history taking, the physiotherapist chooses valid and reliable tests. Information about relevant questions and the validity and or reliability of the tests can be obtained from scientific research. The choice of the intervention also depends on the outcome from scientific research. This whole process is called evidence based clinical reasoning. Ultimately, the point is that, based upon a thorough clinical reasoning process, the physiotherapist can explain why he / she wants to perform a certain intervention that is appropriate for the specific clinical signs and symptoms of a particular patient. This way of matching patient and care is called “matched care”. Matched care is the new innovative approach in treatment and prevention. In this dissertation we refer to this match between diagnostics, interventions and outcome measures as “physiotherapeutic validity”. In order to be able to translate scientific research into daily physiotherapy practice, it is desirable that scientific research is physiotherapeutically valid. Physiotherapeutic validity can be equalled to “external validity”. External validity is the validity of applying the conclusions of a scientific study outside the context of that study. The general aim of this dissertation is to gain insight into the physiotherapeutic validity of physiotherapy research in subjects with non-specific neck pain.
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|Key words||neck pain, physical therapy, diagnosis, validity|