Does a Diagnostic Classification Algorithm Help to Predict the Course of Low Back Pain? A Study of Danish Chiropractic Patients With One-Year Follow Up
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Ce document a été publié dans
journal of orthopaedic and sports physical therapy. 2018-11, vol. 48, n° 11, p. 837-846
Résumé en anglais
Study Design A prospective observational study. Background A diagnostic classification algorithm was developed by Petersen et al., consisting of 12 categories based on a standardized examination protocol with the primary ...Lire la suite >
Study Design A prospective observational study. Background A diagnostic classification algorithm was developed by Petersen et al., consisting of 12 categories based on a standardized examination protocol with the primary purpose of identifying clinically homogeneous subgroups of low back pain (LBP). Objectives To investigate if a diagnostic classification algorithm is associated with activity limitation and LBP intensity at 2-week and 3-month follow up, and 1-year trajectories of LBP intensity, and if it improves prediction of outcome when added to a set of known predictors. Methods 934 consecutive adult patients, with new episodes of LBP, who were visiting chiropractic practices in primary care were categorized according to the Petersen classification. Outcomes were disability and pain intensity measured at 2 weeks and 3 months, and 1-year trajectories of LBP based on weekly responses to text messages. Associations were tested in linear and logistic regression models. In a subgroup of patients, the number of visits to primary and secondary care was described. Results The Petersen classification was statistically significantly associated with all outcomes (p<0.001) but explained very little of the variance (R(2)=0.00-0.05). Patients in the 'Nerve root involvement category' had the most pain and activity limitation and the most visits to primary and secondary care. Patients in the 'myofascial pain category' were the least affected. Conclusion The Petersen classification was not helpful for determining individual prognosis in patients with LBP receiving usual care in chiropractic practice. However, patients should be examined for potential nerve root involvement to improve prediction of likely outcomes. Level of Evidence "Outcomes" research, level 2c. J Orthop Sports Phys Ther, Epub 8 May 2018. doi:10.2519/jospt.2018.8083.< Réduire
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