Association between changes in function among patients with lumbar impairments classified according to the STarT Back Screening Tool and managed by McKenzie credentialed physiotherapists

Werneke, Dip. Mdt Mark W.; Edmond, Susan L.; Young, Cred Mdt Michelle; Grigsby, Cert Mdt David; McClenahan, Brian; McGill, Troy

doi:10.1080/09593985.2018.1490839

Cited by 7 publications

(5 citation statements)

References 41 publications

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“…Briefly, if DP was observed, specific and DP matched exercises and physical activities/movements were prescribed to facilitate symptom centralization (Long et al, ). For patients not demonstrating DP on the first visit, participating physiotherapists performed additional movement testing examining for DP on subsequent visits (Werneke et al, ; Werneke, Hart, & Cook, ). Although there is no consensus on the exact number of visits required to judge DP, our research group agreed that three visits would be adequate to identify DP.…”

Section: Methodsmentioning

confidence: 99%

Directional preference, cognitive behavioural interventions, and outcomes among patients with chronic low back pain

Edmond

Werneke

Young

et al. 2019

Physiotherapy Res Intl

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Objectives Graded activity and graded exposure are recommended cognitive behavioural approaches to improve function and pain outcomes for patients receiving physiotherapy for chronic nonspecific low back pain. Directional preference identified following the McKenzie method is also associated with favourable patient outcomes. Study objectives were to examine associations between graded activity and/or graded exposure, and directional preference or no directional preference combined with or without graded activity/graded exposure subgroups, and function and pain outcomes among patients with chronic nonspecific low back pain managed by clinicians credentialed in the McKenzie approach. Method Cohort study: Subjects (n = 801) with chronic nonspecific low back pain completed intake surveys, that is, the Lumbar Computer Adaptive Test measuring function and the Numeric Pain Rating Scale measuring pain, and questions addressing their demographic, lifestyle, and health status. Directional preference was determined at intake. Treatment with graded activity/graded exposure during the episode of care was recorded. Function and pain measures were repeated at discharge. Two models were developed controlling for potential confounding effects. The first model examined associations between patients receiving versus not receiving graded activity/graded exposure. The second model examined interaction effects between four combinations of directional preference and graded activity/graded exposure. Outcome measures were changes in function and pain during rehabilitation. Results Regarding the first objective, there were no clinically relevant differences between treatment versus no treatment with graded activity/graded exposure, and functional outcomes. Regarding the second objective, patients in the no‐directional preference group were more likely to see benefits from the addition of graded activity/graded exposure to their treatment groups than those with a directional preference. Conclusion Clinicians using McKenzie methods might attain improved patient functional outcomes when augmenting treatment with graded activity and/or graded exposure among patients who do not demonstrate directional preference.

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Section: Methodsmentioning

confidence: 99%

Directional preference, cognitive behavioural interventions, and outcomes among patients with chronic low back pain

Edmond

Werneke

Young

et al. 2019

Physiotherapy Res Intl

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“…Despite the importance of testing stratified care for LBP in different healthcare contexts, few studies have done this, and those published have had different methodological designs (Cherkin et al., 2016 , 2018 ; Riis et al., 2016 ; Riis et al., 2017 ; Werneke et al., 2020 ). The MATCH study (Cherkin et al., 2016 ) was the first study to evaluate the implementation of the stratified care approach outside the UK.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of stratified treatment for back pain in Danish primary care: A randomized controlled trial

Morsø

Olsen

Schiøttz‐Christensen

et al. 2021

European Journal of Pain

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“…Fu and Holmer 38 found that the follow‐up score was a more conservative measure than the change score, with the latter more likely to demonstrate statistically significant results. In addition, there is precedence for this when the focus is on the state of the individual at a specific point in time (e.g., 1 month) versus the change over this time 34,39–42 . Physical function at discharge was recorded as the last follow‐up FOTO survey captured within the episode of care.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, there is precedence for this when the focus is on the state of the individual at a specific point in time (e.g., 1 month) versus the change over this time. 34,[39][40][41][42] Physical function at discharge was recorded as the last follow-up FOTO survey captured within the episode of care.…”

Section: Physical Function At Dischargementioning

confidence: 99%

The relationships between pain‐associated psychological distress, pain intensity, patient expectations, and physical function in individuals with musculoskeletal pain: A retrospective cohort study

Leech

Lulofs-MacPherson

Klopper

et al. 2023

PM&R

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IntroductionThe presence of pain‐associated psychological distress (PAPD) in musculoskeletal disorders, including negative mood, fear‐avoidance, and lack of positive affect/coping, is associated with prolonged disability. The importance of considering psychological influence on pain is well known, but practical ways of addressing it are not as straightforward. Identifying relationships between PAPD and pain intensity, patient expectations, and physical function may guide the development of future studies that assess causality and inform clinical practice.ObjectiveTo assess the relationship between PAPD measured by the Optimal Screening for Prediction of Referral and Outcome—Yellow Flag tool, and baseline pain intensity, expectations of treatment effectiveness, and self‐reported physical function at discharge.DesignRetrospective cohort study.SettingHospital‐based outpatient physical therapy.ParticipantsPatients 18 to 90 years old with spinal pain or lower extremity osteoarthritis.Main Outcome MeasuresPain intensity and patient expectations of treatment effectiveness at intake, and self‐reported physical function at discharge.ResultsA total of 534 patients, 56.2% female, median (interquartile range [IQR]) age 61 (21) years with an episode of care between November 2019 and January 2021 were included. A multiple linear regression showed a significant association between PAPD and pain intensity with 6.4% (p < .001) of the variance explained. PAPD explained 3.3% (p < .001) of the variance in patient expectations. One additional yellow flag present resulted in a 0.17‐point increase in pain intensity and 1.3% decrease in patient expectations. PAPD was also associated with physical function with 3.2% (p < .001) of the variance explained. PAPD explained 9.1% (p < .001) of the variance in physical function at discharge in the low back pain cohort only when assessed independently by body region.ConclusionThese findings support the theory that the pain experience is complex and multiple factors should be considered when evaluating a patient with musculoskeletal pain. Clinicians who have identified PAPD may consider these relationships when planning or modifying interventions and pursuing multidisciplinary collaboration.

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Association between changes in function among patients with lumbar impairments classified according to the STarT Back Screening Tool and managed by McKenzie credentialed physiotherapists

Cited by 7 publications

References 41 publications

Directional preference, cognitive behavioural interventions, and outcomes among patients with chronic low back pain

Directional preference, cognitive behavioural interventions, and outcomes among patients with chronic low back pain

Effectiveness of stratified treatment for back pain in Danish primary care: A randomized controlled trial

The relationships between pain‐associated psychological distress, pain intensity, patient expectations, and physical function in individuals with musculoskeletal pain: A retrospective cohort study

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