Effectiveness of a low back pain classification system

Hall, Hamilton; McIntosh, Greg; Boyle, Christina

doi:10.1016/j.spinee.2009.04.017

Cited by 91 publications

(89 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…48 For a classification system to be clinically useful, the system must enhance patient outcomes as well as account for or include a substantial proportion of potential patients referred to rehabilitation. 9,51 For example, two recent independent studies found that McKenzie syndromes were frequently diagnosed by physical therapists for diverse and large patient populations referred to multiple clinical settings with non-specific spinal pain complaints. 8,9 Hefford reported that of 321 patients, assessed by 34 physical therapists trained in MDT methods, 92% were classified into one of the three McKenzie syndromes.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of classification methods for patients with lumbar impairments using the McKenzie syndromes, pain pattern, manipulation, and stabilization clinical prediction rules

Werneke

Hart²,

Oliver³

et al. 2010

Journal of Manual & Manipulative Therapy

View full text Add to dashboard Cite

Objectives: Aims were (1) to determine the proportion of patients with lumbar impairments who could be classified at intake by McKenzie syndromes (McK) and pain pattern classification (PPCs) using Mechanical Diagnosis and Therapy (MDT) assessment methods, manipulation, and stabilization clinical prediction rules (CPRs) and (2) McK -derangement 67%, dysfunction 5%, posture 0%, other 28%; PPC -CEN 43%, Non CEN 39%, NC 18%; manipulation CPR -positive 13%; Stab CPR -positive 7%. For patients positive for manipulation CPR (n579), prevalence rates for derangement were 89% and CEN 68%. For patients positive for stabilization CPR (n541), prevalence rates for derangement were 83% and CEN 80%. Discussion: The majority of patients classified based on initial clinical presentation by manipulation and stabilization CPRs were also classified as derangements whose symptoms centralized. Manipulation and stabilization CPRs may not represent a mutually exclusive treatment subgroup but may include patients who can be initially treated using a different classification method.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence of classification methods for patients with lumbar impairments using the McKenzie syndromes, pain pattern, manipulation, and stabilization clinical prediction rules

Werneke

Hart²,

Oliver³

et al. 2010

Journal of Manual & Manipulative Therapy

View full text Add to dashboard Cite

show abstract

“…These results provide a rationale for combined use of these stratification tools in LBP models of care in that they each look at different dimensions of LBP (i.e., mechanical pain pattern, degree of disability, and psychosocial wellbeing) and they in-turn also serve to direct a different dimension of treatment. [10][11][12][13][14] With each having their own merit, 12,13 the lack of highly unique subpopulations associated with any one stratification approach is consistent with the findings of Fairbank et al 13 They assessed the role of classification systems of chronic LBP that generally fell into the descriptive diagnostic systems, prognostic, or those that direct treatment, and concluded that no one classification system be adopted for all purposes.…”

Section: Discussionmentioning

confidence: 64%

“…3 Patients with nonspecific LBP are heterogeneous in terms of clinical characteristics and prognosis, and thus are more likely to respond favorably to specific treatment, rather than the current ''one-size-fits-all'' approach. 8,10,11 Evidence warranting moderate to low confidence suggests that a more specific approach to management leads to tailored treatments (i.e., stratified management) and improved outcomes. [10][11][12][13] Using a classification system based on mechanical patterns of symptom dominance and stratified management, Hall et al 10 found improved clinical outcomes compared with nonspecific management in an observational study.…”

mentioning

confidence: 99%

“…8,10,11 Evidence warranting moderate to low confidence suggests that a more specific approach to management leads to tailored treatments (i.e., stratified management) and improved outcomes. [10][11][12][13] Using a classification system based on mechanical patterns of symptom dominance and stratified management, Hall et al 10 found improved clinical outcomes compared with nonspecific management in an observational study. Results of a randomized control trial conducted in the UK suggests that stratified management based on psychosocial factors, using the Keele STarT Back Screening Tool (SBST) that separates LBP patients into low, moderate, and high-risk groups for persistent disabling back pain, is cost-effective compared with usual care.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The Need for Multidimensional Stratification of Chronic Low Back Pain (LBP)

et al. 2015

View full text Add to dashboard Cite

“…Classification and Prognosis: The Task Force did not undertake a systematic literature review, but considered previous work on back pain taxonomy, (4,6,15,24,33,34,44,52,56,74,79,83,101,104,105,117) prognostic classification, (13,19,31,38,39,43,48,49,53,54,(57)(58)(59)(60)(66)(67)(68)73,76,80,82,85,86,97,106,108,110,(112)(113)(114)(115)(116)122) pain and psychosocial measures, (12,31,...…”

Section: Review Of Existing Literature On Back Painmentioning

confidence: 99%

Report of the NIH Task Force on Research Standards for Chronic Low Back Pain

Deyo

Dworkin

Amtmann

et al. 2015

IJTMB

View full text Add to dashboard Cite

Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed non-specific, and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. The NIH Pain Consortium therefore charged a Research Task Force (RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimal data set to describe research participants (drawing heavily on the PROMIS methodology); reporting "responder analyses" in addition to mean outcome scores; and suggestions for future research and dissemination. The Pain Consortium has approved the recommendations, which investigators should incorporate into NIH grant proposals. The RTF believes these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of chronic low back pain. We expect the RTF recommendations will become a dynamic document, and undergo continual improvement. Perspective: A Task Force was convened by the NIH Pain Consortium, with the goal of developing research standards for chronic low back pain.The results included recommendations for definitions, a minimal dataset, reporting outcomes, and future research. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes.KEY WORDS: low back pain; chronic low back pain; research standards; minimum dataset; NIH Task Force introduCtion The Institute of Medicine recently estimated that chronic pain affects about 100 million adults in the United States, with an estimated annual cost of $635 billion, including direct medical expenditures and loss of work productivity. (3) Activity-limiting low back pain (LBP), in particular, has a world-wide lifetime prevalence of about 39% and a similar annual prevalence of 38%. (61) The majority of people having LBP experience recurrent episodes. (62) The use of all interventions for treating chronic LBP (cLBP) increased from 1995-2010, including surgery, pharmacological, and non-pharmacological approaches. Despite increased utilization, however, the prevalence of symptoms and expenditures has increased. 37,70,91

show abstract

Effectiveness of a low back pain classification system

Cited by 91 publications

References 47 publications

Prevalence of classification methods for patients with lumbar impairments using the McKenzie syndromes, pain pattern, manipulation, and stabilization clinical prediction rules

Prevalence of classification methods for patients with lumbar impairments using the McKenzie syndromes, pain pattern, manipulation, and stabilization clinical prediction rules

The Need for Multidimensional Stratification of Chronic Low Back Pain (LBP)

Report of the NIH Task Force on Research Standards for Chronic Low Back Pain

Contact Info

Product

Resources

About