{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:37:30Z","timestamp":1791434250947,"version":"4.3.3"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,6,2]],"date-time":"2024-06-02T00:00:00Z","timestamp":1717286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale<\/jats:title><jats:p>Cervical radiculopathy is initially typically managed conservatively. Surgery is indicated when conservative management fails or with severe\/progressive neurological signs. Personalised multimodal physiotherapy could be a promising conservative strategy. However, aggregated evidence on the (cost\u2010)effectiveness of personalised multimodal physiotherapy compared to surgery with\/without post\u2010operative physiotherapy is lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim\/Objectives<\/jats:title><jats:p>To systematically summarise the literature on the (cost\u2010)effectiveness of personalised multimodal physiotherapy compared to surgery with or without post\u2010operative physiotherapy in patients with cervical radiculopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, Embase, CINAHL, PsycINFO and Web of Science were searched from inception to 1st of March 2023. Primary outcomes were effectiveness regarding costs, arm pain intensity and disability. Neck pain intensity, perceived recovery, quality of life, neurological symptoms, range\u2010of\u2010motion, return\u2010to\u2010work, medication use, (re)surgeries and adverse events were considered secondary outcomes. Randomised clinical trials comparing personalised multimodal physiotherapy versus surgical approaches with\/without post\u2010operative physiotherapy were included. Two independent reviewers performed study selection, data\u2010extraction, and risk of bias assessment using the Cochrane RoB 2 and Consolidated Health Economic Evaluation Reporting Standards statement. Certainty of the evidence was determined using Grading of Recommendations, Assessment, Development and Evaluations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 2109 records, eight papers from two original trials, with 117 participants in total were included. Low certainty evidence showed there were no significant differences on arm pain intensity and disability, except for the subscale \u2018heavy work\u2019 related disability (12 months) and disability at 5\u20138 years. Cost\u2010effectiveness was not assessed. There was low certainty evidence that physiotherapy improved significantly less on neck pain intensity, sensory loss and perceived recovery compared to surgery with\/without physiotherapy. Low certainty evidence showed there were no significant differences on numbness, range of motion, medication use, and quality of life. No adverse events were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Considering the clinical importance of accurate management recommendations and the current low level of certainty, high\u2010quality cost\u2010effectiveness studies are needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.14036","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T04:24:27Z","timestamp":1717388667000},"page":"1227-1238","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["(Cost\u2010)effectiveness of personalised multimodal physiotherapy compared to surgery in patients with cervical radiculopathy: A systematic review"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3542-6296","authenticated-orcid":false,"given":"Sebastiaan","family":"Klein Heerenbrink","sequence":"first","affiliation":[{"name":"Department of Human Movement Sciences Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Program Musculoskeletal Health, Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-7063","authenticated-orcid":false,"given":"Pieter","family":"Coenen","sequence":"additional","affiliation":[{"name":"Department of Public and Occupational Health Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3958-4408","authenticated-orcid":false,"given":"Michel W.","family":"Coppieters","sequence":"additional","affiliation":[{"name":"Department of Human Movement Sciences Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Program Musculoskeletal Health, Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Department of Physiotherapy School of Health Sciences and Social Work, Griffith University Brisbane and Gold Coast Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1606-8742","authenticated-orcid":false,"given":"Johanna M.","family":"van Dongen","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Faculty of Science, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9597-7225","authenticated-orcid":false,"given":"Carmen L. A.","family":"Vleggeert\u2010Lankamp","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Leiden University Medical Center Leiden The Netherlands"},{"name":"Department of Neurosurgery Spaarne Gasthuis Haarlem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6965-3937","authenticated-orcid":false,"given":"Servan","family":"Rooker","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Kliniek ViaSana Mill The Netherlands"},{"name":"Department of Family Medicine and Population Health (FAMPOP) University of Antwerp Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastiaan C.","family":"ter Meulen","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Faculty of Science, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam Amsterdam The Netherlands"},{"name":"Department of Neurology OLVG Teaching Hospital Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes L. 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