Term
| Childs annals of internal medicine 2004 |
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Definition
A Clinical Prediction Rule To Identify Patients with Low Back Pain
Most Likely To Benefit from Spinal Manipulation: A Validation Study |
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Term
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Definition
Conflicting evidence exists about the effectiveness
of spinal manipulation. |
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Term
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Definition
| To validate a manipulation clinical prediction rule |
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Term
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Definition
Patients were randomly assigned to receive ma-
nipulation plus exercise or exercise alone by a physical therapist
for 4 weeks. |
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Term
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Definition
Patients were examined according to the clini-
cal prediction rule criteria (symptom duration, symptom location,
fear–avoidance beliefs, lumbar mobility, and hip rotation range of
motion). Disability and pain at 1 and 4 weeks and 6 months were
assessed. |
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Term
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Definition
Outcome from spinal manipulation depends on a pa-
tient’s status on the prediction rule. Treatment effects are greatest
for the subgroup of patients who were positive on the rule (at
least 4 of 5 criteria met); health care utilization among this sub-
group was decreased at 6 months. Compared with patients who
were negative on the rule and received exercise, the odds of a
successful outcome among patients who were positive on the rule
and received manipulation were 60.8 (95% CI, 5.2 to 704.7). The
odds were 2.4 (CI, 0.83 to 6.9) among patients who were negative
on the rule and received manipulation and 1.0 (CI, 0.28 to 3.6)
among patients who were positive on the rule and received exer-
cise. A patient who was positive on the rule and received manip-
ulation has a 92% chance of a successful outcome, with an
associated number needed to treat for benefit at 4 weeks of 1.9 |
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Term
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Definition
The spinal manipulation clinical prediction rule
can be used to improve decision making for patients with low
back pain |
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Term
| 5 criteria of clinical prediction rule |
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Definition
durations <16days
does not radiate below knee
FABQ <19
1 or more hypomobile lumbar segment
1 hip IR >35 Degrees |
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