Predictors of Improvement in Patients With Acute and Chronic Low Back Pain Undergoing Chiropractic Treatment

Peterson, Cynthia; Bolton, John R.; Humphreys, B. Kim

doi:10.1016/j.jmpt.2012.06.003

Cited by 42 publications

(39 citation statements)

References 33 publications

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“…Only the scores of ‘much better’ or ‘better’ (1 or 2) were counted as clinically relevant improvement. ‘Slightly better’ was not considered to be improved in order to error on the side of caution [16,17]. Statistically significant decreases in all secondary outcome measures at every data collection time point were also found for both groups, although arm pain was somewhat slower to respond in females.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of outcomes in neck pain patients with and without dizziness undergoing chiropractic treatment: a prospective cohort study with 6 month follow-up

Humphreys

Peterson

2013

Chiropr Man Therap

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BackgroundThe symptom ‘dizziness’ is common in patients with chronic whiplash related disorders. However, little is known about dizziness in neck pain patients who have not suffered whiplash. Therefore, the purposes of this study are to compare baseline factors and clinical outcomes of neck pain patients with and without dizziness undergoing chiropractic treatment and to compare outcomes based on gender.MethodsThis prospective cohort study compares adult neck pain patients with dizziness (n = 177) to neck pain patients without dizziness (n = 228) who presented for chiropractic treatment, (no chiropractic or manual therapy in the previous 3 months). Patients completed the numerical pain rating scale (NRS) and Bournemouth questionnaire (BQN) at baseline. At 1, 3 and 6 months after start of treatment the NRS and BQN were completed along with the Patient Global Impression of Change (PGIC) scale. Demographic information was also collected. Improvement at each follow-up data collection point was categorized using the PGIC as ‘improved’ or ‘not improved’. Differences between the two groups for NRS and BQN subscale and total scores were calculated using the unpaired Student’s t-test. Gender differences between the patients with dizziness were also calculated using the unpaired t-test.ResultsFemales accounted for 75% of patients with dizziness. The majority of patients with and without dizziness reported clinically relevant improvement at 1, 3 and 6 months with 80% of patients with dizziness and 78% of patients without dizziness being improved at 6 months. Patients with dizziness reported significantly higher baseline NRS and BQN scores, but at 6 months there were no significant differences between patients with and without dizziness for any of the outcome measures. Females with dizziness reported higher levels of depression compared to males at 1, 3 and 6 months (p = 0.007, 0.005, 0.022).ConclusionsNeck pain patients with dizziness reported significantly higher pain and disability scores at baseline compared to patients without dizziness. A high proportion of patients in both groups reported clinically relevant improvement on the PGIC scale. At 6 months after start of chiropractic treatment there were no differences in any outcome measures between the two groups.

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Section: Discussionmentioning

confidence: 99%

“…The PGIC is a 7 point scale ranging from ‘much better’, ‘better’, slightly better’, no change’, slightly worse’, ‘worse,’ and ‘much worse’. Only the responses of ‘much better’ and ‘better’ were considered clinically relevant improvement [16,17]. …”

Section: Methodsmentioning

confidence: 99%

Comparison of outcomes in neck pain patients with and without dizziness undergoing chiropractic treatment: a prospective cohort study with 6 month follow-up

Humphreys

Peterson

2013

Chiropr Man Therap

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“…293 patients suffering from chronic back pain were treated at private clinics in Switzerland using manual therapy. Significant improvement was reported in their pain levels and disability [9]. In a study conducted by Bronfort et al in 2011 [13] on 301 patients diagnosed with chronic back pain, it was found that supervised exercise improved trunk strength and endurance and produced high levels of patient satisfaction [13].…”

Section: Discussionmentioning

confidence: 97%

“…The importance of a physiotherapist in the rehabilitation of patients needs to be recognized, especially for those diagnosed with chronic musculoskeletal problems. Patients suffering from chronic back pains have better outcomes after rehabilitation [9]. In areas of musculoskeletal rehabilitation, it was found that physiotherapists have the adequate knowledge and expertise and having them in the team ensured faster patient recovery [10].…”

Section: Discussionmentioning

confidence: 99%

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Referring doctors' perspectives about Physiotherapy management for chronic musculoskeletal pain

Rajan¹,

Bellare²

2013

IJTRR

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Background: Patients diagnosed with chronic disabling musculoskeletal pain have better health outcomes and higher levels of satisfaction with Physiotherapy management. A pilot study conducted by the authors found that doctor's referral to Physiotherapy treatment could have affected the satisfaction of the patients towards Physiotherapy management. Objectives:The aim of the current study was to look into the perspectives of referring doctors (physicians and surgeons) towards Physiotherapy as reported by the patients. Secondarily, it was of interest to see how the treatment strategies by the Physiotherapist affect patient satisfaction. Methods: The study was conducted at the orthopedic pain center in the Physiotherapy department at a tertiary care hospital in Mumbai, India. Personal interviews were conducted with 193 patients using a valid questionnaire. Results: The average age of the subjects was 47.5 years. Average duration of pain was close to 8 years, with low back pain being the most common location of pain. Majority of the patients were not referred for any particular Physiotherapy treatment (37.32%). Almost an equal percentage of subjects (33.16%) were referred for both exercise and electrotherapy treatments to the Physiotherapy department. Most of the times (around 68%), there was agreement in the treatment modes suggested by the referring doctor and the attending physiotherapist. However, in about 32% of the patients referred, there seemed to be a mismatch. Conclusion:The referring doctors (physicians/surgeons) gave considerable freedom to the physiotherapists regarding the treatment of chronic musculoskeletal pain. Some of them seemed to recommend electrotherapy as a treatment mode, due to which, there was dissatisfaction amongst patients about the treatment methodologies recommended by the physiotherapist.

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Lumbar nerve root injections: a prospective cohort outcomes study comparing age- and gender-matched patients who returned an outcomes-based postal questionnaire with patients who did not return the postal questionnaire

et al. 2013

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Predictors of Improvement in Patients With Acute and Chronic Low Back Pain Undergoing Chiropractic Treatment

Cited by 42 publications

References 33 publications

Comparison of outcomes in neck pain patients with and without dizziness undergoing chiropractic treatment: a prospective cohort study with 6 month follow-up

Comparison of outcomes in neck pain patients with and without dizziness undergoing chiropractic treatment: a prospective cohort study with 6 month follow-up

Referring doctors' perspectives about Physiotherapy management for chronic musculoskeletal pain

Lumbar nerve root injections: a prospective cohort outcomes study comparing age- and gender-matched patients who returned an outcomes-based postal questionnaire with patients who did not return the postal questionnaire

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