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Which prognostic factors for low back pain are generic predictors of outcome across a range of recovery domains?

Publication ,  Journal Article
Cook, CE; Learman, KE; O'Halloran, BJ; Showalter, CR; Kabbaz, VJ; Goode, AP; Wright, AA
Published in: Phys Ther
January 2013

BACKGROUND: Recovery from low back pain (LBP) is multidimensional and requires the use of multiple-response (outcome) measures to fully reflect these many dimensions. Predictive prognostic variables that are present or stable in all or most predictive models that use different outcome measures could be considered "universal" prognostic variables. OBJECTIVE: The aim of this study was to explore the potential of universal prognostic variables in predictive models for 4 different outcome measures in patients with mechanical LBP. DESIGN: Predictive modeling was performed using data extracted from a randomized controlled trial. Four prognostic models were created using backward stepwise deletion logistic, Poisson, and linear regression. METHODS: Data were collected from 16 outpatient physical therapy facilities in 10 states. All 149 patients with LBP were treated with manual therapy and spine strengthening exercises until discharge. Four different measures of response were used: Oswestry Disability Index and Numeric Pain Rating Scale change scores, total visits, and report of rate of recovery. RESULTS: The set of statistically significant predictors was dependent on the definition of response. All regression models were significant. Within both forms of the 4 models, meeting the clinical prediction rule for manipulation at baseline was present in all 4 models, whereas no irritability at baseline and diagnosis of sprains and strains were present in 2 of 4 of the predictive models. LIMITATIONS: The primary limitation is that this study evaluated only 4 of the multiple outcome measures that are pertinent for patients with LBP. CONCLUSIONS: Meeting the clinical prediction rule was prognostic for all outcome measures and should be considered a universal prognostic predictor. Other predictive variables were dependent on the outcomes measure used in the predictive model.

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Published In

Phys Ther

DOI

EISSN

1538-6724

Publication Date

January 2013

Volume

93

Issue

1

Start / End Page

32 / 40

Location

United States

Related Subject Headings

  • Young Adult
  • Rehabilitation
  • Prognosis
  • Predictive Value of Tests
  • Poisson Distribution
  • Physical Therapy Modalities
  • Middle Aged
  • Male
  • Low Back Pain
  • Logistic Models
 

Citation

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MLA
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Cook, C. E., Learman, K. E., O’Halloran, B. J., Showalter, C. R., Kabbaz, V. J., Goode, A. P., & Wright, A. A. (2013). Which prognostic factors for low back pain are generic predictors of outcome across a range of recovery domains? Phys Ther, 93(1), 32–40. https://doi.org/10.2522/ptj.20120216
Cook, Chad E., Kenneth E. Learman, Bryan J. O’Halloran, Christopher R. Showalter, Vincent J. Kabbaz, Adam P. Goode, and Alexis A. Wright. “Which prognostic factors for low back pain are generic predictors of outcome across a range of recovery domains?Phys Ther 93, no. 1 (January 2013): 32–40. https://doi.org/10.2522/ptj.20120216.
Cook CE, Learman KE, O’Halloran BJ, Showalter CR, Kabbaz VJ, Goode AP, et al. Which prognostic factors for low back pain are generic predictors of outcome across a range of recovery domains? Phys Ther. 2013 Jan;93(1):32–40.
Cook, Chad E., et al. “Which prognostic factors for low back pain are generic predictors of outcome across a range of recovery domains?Phys Ther, vol. 93, no. 1, Jan. 2013, pp. 32–40. Pubmed, doi:10.2522/ptj.20120216.
Cook CE, Learman KE, O’Halloran BJ, Showalter CR, Kabbaz VJ, Goode AP, Wright AA. Which prognostic factors for low back pain are generic predictors of outcome across a range of recovery domains? Phys Ther. 2013 Jan;93(1):32–40.
Journal cover image

Published In

Phys Ther

DOI

EISSN

1538-6724

Publication Date

January 2013

Volume

93

Issue

1

Start / End Page

32 / 40

Location

United States

Related Subject Headings

  • Young Adult
  • Rehabilitation
  • Prognosis
  • Predictive Value of Tests
  • Poisson Distribution
  • Physical Therapy Modalities
  • Middle Aged
  • Male
  • Low Back Pain
  • Logistic Models