Evidence map›Paper›PMID 41979233›Full record

Trial reportPain management2026

Specific and shared mechanisms mediating pain intensity and functional outcomes in chronic neck pain.

Chad E Cook, Bryan O'Halloran, Derek Clewley, Frank Keefe, Cindy Green, Amy McDevitt

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Pain management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05940012 (Specific and Shared Mechanisms Associated With Physical Therapy Interventions), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05940012 nacompletednot on this map

Specific and Shared Mechanisms Associated With Physical Therapy Interventions

TypeinterventionalSponsorDuke UniversityRan2024 to 2025Enrolled122ConditionsChronic Neck PainArmsManual Therapy
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Chad E CookDepartment of Orthopaedics, Duke University School of Medicine, Duke University, Durham, NC, USA.
Bryan O'HalloranIsland Physical Therapy, North Wildwood, NJ, USA.
Derek ClewleyDepartment of Orthopaedics, Duke University School of Medicine, Duke University, Durham, NC, USA.
Frank KeefeDepartment of Psychiatry and Behavioral Sciences, Duke Pain Prevention and Treatment Research Program, Durham, NC, USA.
Cindy GreenDepartment of Orthopaedics, Duke University School of Medicine, Duke University, Durham, NC, USA.
Amy McDevittDepartment of Physical, Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo date, very few studies have used mediation analysis to explore the reasons why people with chronic neck pain improve after physical therapy intervention involving manual therapy or exercise.

objectivesTo evaluate which specific mechanisms (mobility, pain modulation and endurance) and shared mechanisms (self-efficacy, working alliance, engagement, fear, and positive coping) mediated the effects of treatment on clinical outcomes at 4-weeks and 6-months in individuals with chronic neck pain.

methodsThe study incorporated planned indirect‑only mediation analyses to evaluate both specific and shared mechanisms as mediator using data from a mechanistic clinical trial comparing manual therapy and exercise interventions, which demonstrated no between‑group differences. Baseline pain intensity was modeled as the independent variable, and pain interference and physical function at four-weeks and six-months were specified as outcomes. Direct, indirect, and total effects were estimated across four mediation models.

resultsNone of the mediation analyses found specific or shared mechanisms that mediated the relationship of baseline pain intensity to long-term pain interference and physical function. Discussion/Conclusion: Our findings suggest that the absence of significant mediation implies that commonly targeted mechanisms may not be the primary drivers of the relationship of pain intensity to longer-term pain interference or physical function. CLINICAL

trial registrationwww.clinicaltrials.gov identifier is NCT05940012.

Indexed as

Chronic PainExercise TherapyMusculoskeletal ManipulationsNeck PainAdaptation, PsychologicalAdultFemaleHumansMaleMediation AnalysisMiddle AgedPain MeasurementSelf EfficacyTreatment OutcomeManual therapymechanismsmediation analysisneck painphysical therapy

Identifiers

PMID41979233
PMCPMC13336280

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.