Articles: low-back-pain.
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Arch Phys Med Rehabil · Aug 2018
Randomized Controlled TrialPredictive Validity of the STarT Back Tool for Risk of Persistent Disabling Back Pain in a U.S. Primary Care Setting.
To examine the predictive validity of the Subgrouping for Targeted Treatment (STarT Back) tool for classifying people with back pain into categories of low, medium, and high risk of persistent disabling back pain in U.S. primary care. ⋯ The STarT Back risk groups successfully separated people with back pain into distinct categories of risk for persistent disabling back pain at 6-month follow-up in U.S. primary care. These results were very similar to those in the original STarT Back validation study. This validation study is a necessary first step toward identifying whether the entire STarT Back approach, including matched/targeted treatment, can be effectively used for primary care in the United States.
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Prospective cohort. ⋯ 2.
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Clinical biomechanics · Aug 2018
Randomized Controlled Trial Multicenter Study Observational StudyEffects of supplemental heat therapy in multimodal treated chronic low back pain patients on strength and flexibility.
The beneficial effects of thermotherapy on analgesia and relaxation are widely known for various diseases. To date, however, thermotherapy in chronic low back pain is not explicitly recommended in international guidelines. The effects of thermotherapy on biomechanical parameters within a multimodal back pain treatment concept are also unknown. ⋯ The implementation of thermotherapy for several hours a day (heat wrap therapy) in daily clinical practice additional to an individualized, evidence-based multimodal treatment concept can be recommended to enhance strength parameters. The potential causes of improved strength parameters as well as the meaning for the patients in activity of daily living are discussed.
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Review Observational Study
[Avoidance-endurance fast screening (AE-FS) : Content and predictive validity of a 9‑item screening instrument for patients with unspecific subacute low back pain].
Among screening measures to assess psychosocial risk factors (yellow flags) for chronic low back pain (LBP) economic tools which address dysfunctional endurance pain responses besides emotional distress and fear-avoidance pain processing are rare. Targeting contrasting types of pain processing might improve stratified patient counselling. ⋯ The 9‑item AE-FS displayed sufficient prognostic validity for all three outcomes in a sample of primary care patients with subacute LBP. The differentiation of the high-risk patients into fear-avoidance and endurance-related pain processing enables the physician to provide an individualized counselling with the aim of a healthy balance between stress and relaxation.
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The objective of this study was to investigate the frequency with which prediction studies for low back pain outcomes utilize prospective methods of prognostic model validation. ⋯ Unless researchers and clinicians consider sophisticated and rigorous methods of statistical/external validity for prediction/prognostic findings they will make incorrect assumptions and draw invalid conclusions regarding treatment effects and outcomes. Without proper validation methods, studies that claim to present prediction models actually describe only traits or characteristics of the studied sample.