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Objective <p>To summarize evidence for physical measures of physical functioning as prognostic factors in predicting outcomes in people with neck and thoracic pain.</p> Methods <p>A comprehensive search was performed on 01/09/2025 across key databases (MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science), the grey literature (ProQuest), handsearches of key journals, and reference lists. Eligible studies were prospective longitudinal cohort studies. Two reviewers independently performed study selection, data extraction, risk of bias (RoB) assessment using Quality in Prognostic Studies (QUIPS) tool, and quality of evidence using GRADE (Grading of Recommendations Assessment, Development, and Evaluation). Owing to substantial clinical and methodological heterogeneity, findings were synthesized narratively by grouping studies according to outcome type, physical measure, and follow-up timepoints.</p> Results <p>Twenty-two studies (10 high, 7 moderate, 5 low RoB) were included. Low level evidence supports higher cervical movement velocity in the frontal plane predicting lower short-term (&lt; 3 months) disability for people with neck pain. Low to very low evidence suggests cervical active range of motion (frontal and transverse planes), cervical movement velocity (sagittal and transverse planes), spring test, joint position error (transverse plane), and endurance of deep neck flexors were not predicting pain, disability and good overall changes in the short-term and mid-term (3 to 12-month) for neck pain. Inconsistent associations were also found for multiple measures in the short-and mid-term outcomes, with very low evidence. No studies addressed any measures for thoracic pain.</p> Conclusion <p>The overall evidence was consistently low, precluding strong conclusions. Cervical movement velocity may be a potential predictor of short-term disability for neck pain to inform clinical decision making. There is an urgent need for low RoB prospective longitudinal cohort studies with standardized prognostic factors and outcomes measurement to further investigate physical measures of physical functioning as candidate prognostic factors for people with neck pain. Evidence for thoracic pain was entirely lacking, highlighting the need for a future prognostic studies for thoracic pain.</p>

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Physical measures of physical functioning as prognostic factors in predicting outcomes for neck and thoracic pain: a systematic review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月29日

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  • Rabea Begum,
  • Alaa El Chamaa,
  • Paul Parikh,
  • David Walton,
  • Alison Rushton

摘要

Objective

To summarize evidence for physical measures of physical functioning as prognostic factors in predicting outcomes in people with neck and thoracic pain.

Methods

A comprehensive search was performed on 01/09/2025 across key databases (MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science), the grey literature (ProQuest), handsearches of key journals, and reference lists. Eligible studies were prospective longitudinal cohort studies. Two reviewers independently performed study selection, data extraction, risk of bias (RoB) assessment using Quality in Prognostic Studies (QUIPS) tool, and quality of evidence using GRADE (Grading of Recommendations Assessment, Development, and Evaluation). Owing to substantial clinical and methodological heterogeneity, findings were synthesized narratively by grouping studies according to outcome type, physical measure, and follow-up timepoints.

Results

Twenty-two studies (10 high, 7 moderate, 5 low RoB) were included. Low level evidence supports higher cervical movement velocity in the frontal plane predicting lower short-term (< 3 months) disability for people with neck pain. Low to very low evidence suggests cervical active range of motion (frontal and transverse planes), cervical movement velocity (sagittal and transverse planes), spring test, joint position error (transverse plane), and endurance of deep neck flexors were not predicting pain, disability and good overall changes in the short-term and mid-term (3 to 12-month) for neck pain. Inconsistent associations were also found for multiple measures in the short-and mid-term outcomes, with very low evidence. No studies addressed any measures for thoracic pain.

Conclusion

The overall evidence was consistently low, precluding strong conclusions. Cervical movement velocity may be a potential predictor of short-term disability for neck pain to inform clinical decision making. There is an urgent need for low RoB prospective longitudinal cohort studies with standardized prognostic factors and outcomes measurement to further investigate physical measures of physical functioning as candidate prognostic factors for people with neck pain. Evidence for thoracic pain was entirely lacking, highlighting the need for a future prognostic studies for thoracic pain.