Results of an International Survey of Practice Patterns for Establishing Prognosis in Neck Pain: The ICON Project

David M Walton*, 1, Joy C MacDermid2, P. Lina Santaguida3, Anita Gross4, Lisa Carlesso3, ICON
1 School of Physical Therapy, Western University, London Ontario, Canada
2 School of Rehabilitation Sciences, McMaster University, Hamilton Ontario, and Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre, London Ontario, Canada
3 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton Ontario, Canada
4 School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
5 International Collaboration on Neck (ICON)

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© Walton et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Rm. EC1443, School of Physical Therapy, Western University, 1201 Western Rd., London, ON N6H 1A1, Canada; Tel: 519-661-2111, Ext. 80145; Fax: 519-661-3866; E-mail:


Results of an international survey of health care providers for neck pain are reported. The survey specifically collected self-reported practice patterns for establishing a prognosis in neck pain. Over 440 responses from 27 countries were collected. Descriptive results indicate that respondents assigned large prognostic impact to factors including mechanism of injury and psychological or behavioral constructs. Range of motion, age and sex were routinely collected despite relatively moderate impact on prognosis. A comparison between chiropractic and manual/physical therapy groups showed differences in practice patterns that were unlikely to affect prognostic accuracy. The results suggest a gap exists between current best-evidence and actual practice when the goal is to establish a prognosis in neck pain.

Keywords: Pain, prognosis, outcomes, survey, neck.