Patient expectations of benefit from interventions for neck pain and resulting influence on outcomes.

(Bishop, Mintken, Bialosky, & Cleland, 2013)

Aims: To (1) examine patients’ general expectations for treatment by physical therapists and specific expectations for common interventions in patients with neck pain, and (2) to assess the extent to which the patients’ general and specific expectations for treatment, particularly spinal manipulation, affect clinical outcomes.

Methods: Retrospective cohort. 140 patients with neck pain, were asked for expectations. Randomly allocated to 2 groups: stretching / strengthening, vs manip / mob / stretching / strengthening. Analysis of relationship between satisfaction of expectation and outcomes at 1 and 6 months calculated.

Results: 137 at 1 month and 114 patients at 6 months. Better expectations led to better outcomes. At 1 and 6 months patients who received what expected did better than those who did not.

Limitations: Statistical analysis / 6 month = is it still the result of 2 sessions of manip? / dropouts / voluntary basis

In practice: Patients with expectations of relief do better. Patient who’s expectations are met tend to do better than the opposite.

Bishop, M. D., Mintken, P., Bialosky, J. E., & Cleland, J. A. (2013). Patient Expectations of Benefit From Interventions for Neck Pain and Resulting Influence on Outcomes. Journal of Orthopaedic & Sports Physical Therapy, 43(7), 457–465.

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