Articles: low-back-pain.
-
Understanding prognosis is important in managing low back pain. In this article, we discuss the available evidence on low back pain prognosis and describe how prognostic evidence can be used to inform clinical decision making. We describe three main types of related prognosis questions: 'What is the most likely course?' (Course studies); 'What factors are associated with, or determine, outcome?' (Prognostic factor or explanatory studies); and 'Can we identify risk groups who are likely to have different outcomes?' (Risk group or outcome prediction studies). ⋯ Important low back pain prognostic factors are related to the back pain episode, the individual and psychological characteristics, as well as the work and social environment. Although numerous studies have developed prediction models in the field, most models/tools explain less than 50% of outcome variability and few have been tested in independent samples. We discuss limitations and future directions for research in the area of low back pain prognosis.
-
Comparative Study
[A comparison of multimodal programmes of patient education in the rehabilitation of chronic low back pain].
There is growing evidence for the effectiveness of multimodal intervention concepts for chronic low back pain in the international literature, and accordingly several German rehabilitation programmes for the treatment of chronic low back pain patients have been developed. Focus of this paper is to describe and compare frequently used German multimodal intervention programmes for in- and outpatient rehabilitation of patients with chronic low back pain. Programmes were chosen by searching the most relevant online resources as well as the online pages of Deutsche Rentenversicherung and Zentrum Patientenschulung during September 2008. ⋯ These programmes are depicted and compared with regard to their potentials and limitations in supporting the rehabilitation process of patients with chronic low back pain. While comparing the programmes, a number of similarities between them can be detected, as well as pronounced differences, e. g., regarding settings and complexity. In most programmes, lack of appropriate evaluation studies and lack of aftercare turn out to be critical aspects.
-
Validation of a translated, culturally adapted questionnaire. ⋯ Despite linguistic and cultural differences, the Korean version of the CPCI-42 is overall a meaningful tool, and produces results sufficiently similar to the original CPCI-42.
-
Original report. ⋯ The putative negative correlation between DOS and outcome was not observed under any analysis in our study. PLIF procured a rapid and sustained improvement in CLBP, even where the DOS was excessively prolonged; and even after having allowed for pain severity. Symptom chronicity, therefore, does not represent a poor prognostic indicator for CLBP outcome after PLIF: PLIF should be considered irrespective of DOS. Because DOS and pain severity are likely mediators of "central sensitization," the hypothesis that central sensitization may be prevalent in CLBP patients selected for PLIF is therefore questioned.
-
Observational Study
Appropriateness criteria for surgery improve clinical outcomes in patients with low back pain and/or sciatica.
Prospective, controlled, observational outcome study using clinical, radiographic, and patient/physician-based questionnaire data, with patient outcomes at 12 months follow-up. ⋯ In comparison to previously reported literature, our study is the first to assess the utility of appropriateness criteria for low back surgery at 1-year follow-up with multiple outcome dimensions. Our results confirm the hypothesis that application of appropriateness criteria can significantly improve patient outcomes.