Physical measures of physical functioning as prognostic factors in predicting outcomes for neck and thoracic pain: a systematic review
Bibliographic record
Abstract
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.
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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 | 0.011 | 0.052 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.009 |
| Bibliometrics | 0.011 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".