| Derivation of a Preliminary Clinical Prediction Rule for Identifying a Sub-Group of Patients With Low Back Pain Likely to Benefit From Pilates-Based Exercise. | |
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MedLine Citation:
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PMID: 22281950 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} STUDY DESIGN: Prospective cohort study. OBJECTIVE: To derive a preliminary clinical prediction rule for identifying a sub-group 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 work has previously been done to characterize patient attributes for those most likely to have a successful outcome from treatment. METHODS: Ninety six individuals with non-specific low back pain participated in the study. Treatment response was categorized based on changes in the Oswestry Disability Questionnaire (ODQ) 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 (ROC), and regression analyses were used to determine the association between standardized examination variables and treatment response status. RESULTS: Ninety five of the 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 ROM of 70 degrees or less, duration of current symptoms of 6 months or less, no leg symptoms in the last week, body mass Index (BMI) of 25 or greater, and left or right hip average rotation of 25 degrees 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. J Orthop Sports Phys Ther, Epub 25 January 2012. doi:10.2519/jospt.2012.3826. |
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Authors:
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Lise R Stolze; Stephen C Allison; John D Childs |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-25 |
Journal Detail:
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Title: The Journal of orthopaedic and sports physical therapy Volume: - ISSN: 1938-1344 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7908150 Medline TA: J Orthop Sports Phys Ther Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
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