Document Detail


Derivation of a preliminary clinical prediction rule for identifying a subgroup of patients with low back pain likely to benefit from Pilates-based exercise.
MedLine Citation:
PMID:  22281950     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Prospective cohort study.
OBJECTIVE: To derive a preliminary clinical prediction rule for identifying a subgroup of patients with low back pain (LBP) likely to benefit from Pilates-based exercise.
BACKGROUND: Pilates-based exercise has been shown to be effective for patients with LBP. However, no previous work has characterized patient attributes for those most likely to have a successful outcome from treatment.
METHODS: Ninety-six individuals with nonspecific LBP participated in the study. Treatment response was categorized based on changes in the Oswestry Disability Questionnaire scores after 8 weeks. An improvement of 50% or greater was categorized as achieving a successful outcome. Thirty-seven variables measured at baseline were analyzed with univariate and multivariate methods to derive a clinical prediction rule for successful outcome with Pilates exercise. Accuracy statistics, receiver-operator curves, and regression analyses were used to determine the association between standardized examination variables and treatment response status.
RESULTS: Ninety-five of 96 participants completed the study, with 51 (53.7%) achieving a successful outcome. A preliminary clinical prediction rule with 5 variables was identified: total trunk flexion range of motion of 70° or less, duration of current symptoms of 6 months or less, no leg symptoms in the last week, body mass index of 25 kg/m2 or greater, and left or right hip average rotation range of motion of 25° or greater. If 3 or more of the 5 attributes were present (positive likelihood ratio, 10.64), the probability of experiencing a successful outcome increased from 54% to 93%.
CONCLUSION: These data provide preliminary evidence to suggest that the response to Pilates-based exercise in patients with LBP can be predicted from variables collected from the clinical examination. If subsequently validated in a randomized clinical trial, this prediction rule may be useful to improve clinical decision making in determining which patients are most likely to benefit from Pilates-based exercise.
Authors:
Lise R Stolze; Stephen C Allison; John D Childs
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2012-01-25
Journal Detail:
Title:  The Journal of orthopaedic and sports physical therapy     Volume:  42     ISSN:  1938-1344     ISO Abbreviation:  J Orthop Sports Phys Ther     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-02     Completed Date:  2012-09-06     Revised Date:  2012-11-07    
Medline Journal Info:
Nlm Unique ID:  7908150     Medline TA:  J Orthop Sports Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  425-36     Citation Subset:  IM    
Affiliation:
Graduate Program in Orthopedics, Rocky Mountain University of Health Professions, Provo, UT, USA. Lstolze@regis.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Exercise Movement Techniques / methods*
Exercise Therapy / methods*
Female
Humans
Low Back Pain / therapy*
Male
Middle Aged
Patient Selection
Questionnaires
ROC Curve
Range of Motion, Articular / physiology
Treatment Outcome
Comments/Corrections
Comment In:
Sportverletz Sportschaden. 2012 Sep;26(3):133

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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