Clinical prediction rule validity to identify individuals with recurrent low back pain

Abstract

IntroductionOne set of clinical prediction rules (CPR) can be used clinically to identify patients with low back pain who are likely to benefit from motor control exercise. Individuals with a history of recurrent low back pain during remission (rLBP) still have persisting impaired trunk neuromuscular control. Accordingly, CPR should detect these individuals with rLBP. This study aimed to determine the predictive validity of CPR to identify individuals with rLBP.MethodsOverall, 30 subjects aged less than 40 years (22 subjects with rLBP and 8 subjects without a history of low back pain) were recruited. We used the following criteria as CPR: (1) presence of aberrant movement during active forward bend and (2) passive straight leg raising result greater than 91°. Kappa statistics and the chi-square test were used to determine predictive validity. Diagnostic accuracy was also calculated.ResultsKappa demonstrated substantial agreement (kappa = 0.73), while the chi-square test showed significant association (χ<sup>2</sup> = 16.28; <i>p</i> < 0.001) between positive CPR and rLBP. Diagnostic accuracy demonstrated positive likelihood ratio of 3.82, while accuracy equalled 90%.ConclusionsOur findings indicated the predictive validity of CPR to identify individuals with rLBP. The result from this study would help identify those predisposed to recurrent episodes of low back pain who would likely have a positive response to motor control exercise.

Effects of Lumbar Manipulation Spinal in Patients with Pain Caused by a Lumbar Disc Herniation: A Systematic Review

“…Research has found that the 1-year incidence of first ever low back pain episode ranges from 6.3% to 15.4%, while the 1-year incidence of recurrent low back pain episodes ranges from 24% to 80% 2 . The prevalence of low back pain during a person's life has been established at around 70-80% 3,4 .…”