Neck pain and emotional state in cervical spondylosis: A dual trajectory model analysis
Bibliographic record
Abstract
BACKGROUND Neck pain, a primary symptom of cervical spondylosis, affects patients’ physical and mental health, reducing their quality of life. Pain and emotional state interact; however, their longitudinal interrelationship remains unclear. In this study, we applied a dual-trajectory model to assess how neck pain and emotional state evolve together over time and how clinical interventions, particularly acupuncture, influence these trajectories. AIM To investigate the longitudinal relationship between neck pain and emotional state in patients with cervical spondylosis. METHODS This prospective cohort study included 472 patients with cervical spondylosis from eight Chinese hospitals. Participants received acupuncture or medication and were followed up at baseline, and at 1, 2, 4, 6, and 8 weeks. Neck pain and emotional distress were assessed using the Northwick Park Neck Pain Questionnaire (NPQ) and the affective subscale of the Short-Form McGill Pain Questionnaire (SF-MPQ), respectively. Group-based trajectory models and dual trajectory analysis were used to identify and correlate pain-emotion trajectories. Multivariate logistic regression identified predictors of group membership. RESULTS Three trajectory groups were identified for NPQ and SF-MPQ scores (low, medium, and high). Higher NPQ trajectory was associated with older age (OR = 1.058, P < 0.001) and was significantly reduced by acupuncture (OR = 0.382, P < 0.001). Similarly, acupuncture lowered the odds of high SF-MPQ trajectory membership (OR = 0.336, P < 0.001), while age increased it (OR = 1.037, P < 0.001). Dual-trajectory analysis revealed bidirectional associations: 69.1% of patients with low NPQ had low SF-MPQ scores, and 42.6% of patients with high SF-MPQ also had high NPQ scores. Gender was a predictor for medium SF-MPQ trajectory (OR = 1.629, P = 0.094). Occupation and education levels differed significantly across the trajectory groups (P < 0.05). CONCLUSION Over time, neck pain and emotional distress are closely associated in patients with cervical spondylosis. Acupuncture alleviates both outcomes significantly, while age is a risk factor. Integrated approaches to pain and emotional management are encouraged.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.009 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.004 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".