Figure 1.
Results of the decision tree analysis of the patient characteristics that best define the clinical scenarios where mobilization was rated inappropriate
CNP = chronic neck (cervical) pain
1Red flags = Those factors where the risk may outweigh the benefit, such as: fever greater than 100 degrees F; prolonged corticosteroid use; unexplained weight loss; history of cancer; history of serious systemic inflammatory arthritides or vasculitides; endocrinopathies that affect calcium metabolism.
2Major neurologic findings = A At least one of the following: neurologic signs of cervical myelopathy; progressive unilateral muscle weakness and/or motor loss documented by repeat exam over time; sensory deficits other than related to dermatomes or peripheral nerves; and/or electrodiagnostic findings of acute and/or progressive radiculopathy.
3Minor neurologic findings = At least one of the following: asymmetrically decreased reflexes in upper extremity; documented dermatomal or peripheral nerve sensory changes which may include deficit, paresthesia, and hyperesthesia; non-progressive unilateral muscle weakness and/or parasthesia that follows a radicular pattern.