Predictors of improvement in community adolescents with chronic neck pain: A secondary analysis using different improvement criteria.

Background: Interventions based on pain neuroscience education and exercise have emerged as effective in the management of chronic neck pain in adolescents. No studies have explored factors that might be associated with recovery in adolescents with neck pain.

Objective: To explore predictors of improvement after an intervention based on exercise and pain neuroscience education.

Design: Secondary analysis of a randomized trial.

Setting: Community.

Participants: 127 community adolescents with neck pain.

Interventions: Blended-learning intervention based on exercise and pain neuroscience education.

Main outcome measures: A set of variables including sociodemographic data, pain characteristics, physical activity, disability, sleep, catastrophizing, fear of movement, self-efficacy, symptoms of central sensitization, knowledge of pain neuroscience, pressure pain thresholds, and neck muscles endurance were used to predict a clinical response at 1 week after intervention and at 6-month follow-up.

Results: Different predictors of improvement and non-improvement to intervention were found, but common predictors were not found for all the improvement criteria explored and time points.

Conclusions: These findings suggest that using different criteria to characterize adolescents with neck pain as improved and non-improved after pain neuroscience education and exercise have an effect on the variables associated with a response to the intervention.