The relationship between Quebec Task Force Classification and outcome in patients with low back pain treated through mechanical diagnosis and therapy

Schenk, Ron; Lawrence, Helen; Lorenzetti, Joseph; Marshall, William B.J.; Whelan, Gillian; Zeiss, Russell

doi:10.1179/2042618614y.0000000102

Cited by 7 publications

(8 citation statements)

References 21 publications

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“…Eligible patients were ≥35 years old with CLBP and history of inadequate pain relief or intolerance to analgesic therapy, including acetaminophen, at least one oral NSAID and at least one opioid (or unwillingness to take opioids), and a diagnosis of moderate-to-severe CLBP (Quebec Task Force category 1: no radiating pain, or Quebec Task Force category 2: proximal radiation above the knee) 22 for ≥3 months prior to screening. An LBP intensity Numeric Rating Scale (LBPI NRS) score ≥4 at both screening and at randomisation (after withdrawal of previous pain medication(s), without requirement for pain flare), and a Patient Global Assessment (PGA) of LBP of fair, poor or very poor at screening were also required.…”

Section: Methodsmentioning

confidence: 99%

Efficacy and safety of fasinumab in patients with chronic low back pain: a phase II/III randomised clinical trial

et al. 2020

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ObjectivesTo study the efficacy and safety of fasinumab in moderate-to-severe, chronic low back pain (CLBP).MethodsIn this phase II/III, double-blind, placebo-controlled study, patients with CLBP aged ≥35 years with inadequate pain relief/intolerance to acetaminophen, non-steroidal anti-inflammatory drugs and opioids were randomised to fasinumab 6 or 9 mg subcutaneous every 4 weeks (Q4W), 9 mg intravenous every 8 weeks (Q8W) or placebo. Primary endpoint was change from baseline to week 16 in average daily low back pain intensity (LBPI) numeric rating score. Key secondary efficacy variables included Roland-Morris Disability Questionnaire (RMDQ) and Patient Global Assessment (PGA). The results are based on a modified intent-to-treat analysis of 563/800 planned patients when enrolment was stopped early given emerging signals of joint risk in other osteoarthritis (OA) studies at doses being tested here.ResultsSignificant placebo-adjusted LBPI reductions at week 16 were observed for fasinumab 9 mg Q4W and Q8W (least squares mean (standard error) −0.7 (0.3); both nominal p<0.05), but not 6 mg (–0.3 (0.3); p=0.39). RMDQ and PGA improvements to week 16 were greatest for fasinumab 9 mg intravenous. Numerically greater efficacy occurred in patients with, versus those without, peripheral OA (pOA) over 16 weeks. Treatment-emergent adverse events (AEs) occurred in 274/418 (65.6%) patients in the combined fasinumab groups and 94/140 (67.1%) placebo patients. Joint AEs, mostly rapid progressive OA type 1, were more frequent in the combined fasinumab groups (19 events in 16 patients (3.8%) vs 1 event in 1 patient (0.7%) for placebo); all except one occurred in pOA patients.ConclusionsFasinumab highest doses, but not lower dose, improved both CLBP pain and function. Most joint AEs occurred in pOA patients, consistent with earlier findings in symptomatic OA. Further study is needed of patients with CLBP with and without pOA to determine optimal benefit–risk.

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Section: Methodsmentioning

confidence: 99%

Efficacy and safety of fasinumab in patients with chronic low back pain: a phase II/III randomised clinical trial

et al. 2020

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“…The inclusion criteria were: Spanish subjects, aged >18 years, and normal (no pain) participants or participants with nonspecific acute or subacute LBP 11,12,14,15,17. A nonspecific pain condition was defined as soreness of mechanical origin 17.…”

Section: Methodsmentioning

confidence: 99%

“…A nonspecific pain condition was defined as soreness of mechanical origin 17. Furthermore, LBP was considered as pain predominantly located in the posterior trunk region, between the subcostal line and the upper part of the iliac bones 12–15.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, LBP was considered as pain predominantly located in the posterior trunk region, between the subcostal line and the upper part of the iliac bones 12–15. Finally, acute and subacute LBP were categorized as pain of <12 weeks’ duration,14,15 in keeping with The Quebec Task Force on Spinal Disorders LBP categorization, as acute (<2–4 weeks), subacute (up to 12 weeks), and chronic (>12 weeks) 17,18…”

Section: Methodsmentioning

confidence: 99%

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Relationship of depression in participants with nonspecific acute or subacute low back pain and no-pain by age distribution

Calvo‐Lobo¹,

Fernández²,

Becerro-de-Bengoa-Vallejo³

et al. 2017

JPR

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Background and purposeNonspecific low back pain (LBP) is the most prevalent musculoskeletal condition in various age ranges and is associated with depression. The aim of this study was to determine the Beck Depression Inventory (BDI) scores in participants with nonspecific LBP and no-pain by age distribution.MethodsA case–control study was carried out following the Strengthening the Reporting of Observational Studies in Epidemiology criteria. A sample of 332 participants, divided into the following age categories: 19–24 (n=11), 25–39 (n=66), 40–64 (n=90), 65–79 (n=124), and ≥80 (n=41) years was recruited from domiciliary visits and an outpatient clinic. The BDI scores were self-reported in participants with nonspecific acute or subacute (≤3 months) LBP (n=166) and no-pain (n=166).ResultsThe BDI scores, mean ± standard deviation, showed statistically significant differences (p<0.001) between participants with nonspecific acute or subacute LBP (9.590±6.370) and no-pain (5.825±5.113). Significantly higher BDI scores were obtained from participants with nonspecific acute and subacute LBP in those aged 40–64 years (p<0.001; 9.140±6.074 vs 4.700±3.777) and 65–79 years (p<0.001; 10.672±6.126 vs 6.210±5.052). Differences were not significant in younger patients aged 19–24 (p=0.494; 5.000±2.646 vs 8.250±7.498), 25–39 (p=0.138; 5.440±5.245 vs 3.634±4.397), and in those aged ≥80 years (p=0.094; 13.625±6.1331 vs 10.440±5.591).ConclusionParticipants with nonspecific acute and subacute LBP present higher BDI depression scores, influenced by age distribution. Specifically, patients in the age range from 40 to 80 years with LBP could require more psychological care in addition to any medical or physical therapy. Nevertheless, physical factors, different outcomes, and larger sample size should be considered in future studies.

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“…Hence, we wanted to underline that selecting a homogeneous group of LBP patients using the mechanical diagnosis and therapy method (MDT) [ 18 ] and Quebec Task Force Classification (QTFC) can lead to a higher sensitivity of the study [ 19 , 20 ]. In conclusion of this above, we believe that this article will highlight the causes of discrepancy in the results of the body balance tests and underline the necessity of applying a reliable examination in inclusion criteria of LBP patients.…”

Section: Introductionmentioning

confidence: 99%

Impairment of Proprioception in Young Adult Nonradicular Patients with Lumbar Derangement Syndrome

Olszewska-Karaban

Permoda-Białozorczyk²,

Dąbrowska

et al. 2021

BioMed Research International

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Maintaining body balance is a complex function based on the information deriving from the vestibular, visual, and proprioceptive systems. The aim of the study was to evaluate quiet single stance stability in young adults with lumbar derangement syndrome (LDS) and in the control group of the healthy subjects. The second aim of this study was to determine whether pain intensity, degree of disability, and the level of physical activity can influence postural control in patients with LDS. It is important to underline that selecting a homogeneous group of LBP patients using, for example, mechanical diagnosis and therapy method and Quebec Task Force Classification, can result in an increased sensitivity of the study. The study included 126 subjects: 70 patients with LDS (37 women, 33 men) and the control group 56 healthy volunteers (36 women, 20 men). In case of multiple group comparisons for variables with normal distribution, ANOVA post hoc test was used or, as the nonparametric equivalent, Kruskal-Wallis test. In all these calculations, the statistical significance level was set to p < 0.05 . The stability index eyes open for the study group was 88.34 and for the control group 89.86. There was no significant difference in the level of postural control between the study and control groups ( p > 0.05 ). The level of stability index eyes closed (SI EC) for the study group was 71.44 and for the control group 77.1. SI EC results showed significant differences in proprioceptive control during single leg stance between the study and control groups ( p < 0.05 ). The level of pain intensity, the degree of disability, and physical activity level did not influence postural control in the study group with LDS. In summary, patients with LDS showed significantly worse proprioceptive control.

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The relationship between Quebec Task Force Classification and outcome in patients with low back pain treated through mechanical diagnosis and therapy

Cited by 7 publications

References 21 publications

Efficacy and safety of fasinumab in patients with chronic low back pain: a phase II/III randomised clinical trial

Efficacy and safety of fasinumab in patients with chronic low back pain: a phase II/III randomised clinical trial

Relationship of depression in participants with nonspecific acute or subacute low back pain and no-pain by age distribution

Impairment of Proprioception in Young Adult Nonradicular Patients with Lumbar Derangement Syndrome

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