Interrater reliability of a new classification system for patients with neural low back-related leg pain.

The aim of this study was to investigate the reliability of a new classification system for low back-related leg pain arising from neural tissue dysfunction. Leg pain is a frequent accompaniment to back pain and is an indicator of the severity and prognosis of the disorder. For optimal patient care,...

Full description

Bibliographic Details
Published in:Journal of Manual & Manipulative Therapy (Journal of Manual & Manipulative Therapy) Vol. 17; no. 2; pp. 109 - 118
Main Authors: Schäfer A, Hall TM, Lüdtke K, Mallwitz J, Briffa NK
Format: research tables/charts Journal Article
Published: Journal of Manual & Manipulative Therapy 2009
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105443420&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 105443420
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        10669817
        1DS
      jtl: Journal of Manual & Manipulative Therapy (Journal of Manual & Manipulative Therapy)
      issn: 10669817
      maglogo: N
    pubinfo:
      dt: 2009
      vid: 17
      iid: 2
      pid: 2525
      pub: Journal of Manual & Manipulative Therapy
      place: Forest Grove, Oregon
    artinfo:
      ui:
        105443420
        2010403200
        10.1179/106698109790824730
        NLM20046553
        PMC2700493
        105443420
      ppf: 109
      ppct: 9
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Interrater reliability of a new classification system for patients with neural low back-related leg pain.
      aug:
        au:
          Schäfer A
          Hall TM
          Lüdtke K
          Mallwitz J
          Briffa NK
      sug:
        subj:
          Leg Physiopathology
          Low Back Pain
          Pain Classification
          Pain Etiology
          Peripheral Nerves Physiopathology
          Adult
          Clinical Assessment Tools
          Confidence Intervals
          Descriptive Statistics
          Female
          Interrater Reliability
          kappa Statistic
          Male
          Middle Age
          Physical Examination
          Power Analysis
          Psychological Tests
          Questionnaires
          Sample Size
          Scales
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: The aim of this study was to investigate the reliability of a new classification system for low back-related leg pain arising from neural tissue dysfunction. Leg pain is a frequent accompaniment to back pain and is an indicator of the severity and prognosis of the disorder. For optimal patient care, treatment should be directed according to the identified pathophysiological mechanisms. The authors have proposed a sub-classification of neural low back-related leg pain into four categories, each requiring a different management strategy: Central Sensitization (CS), comprising major features of sensitization of the somatosensory system; Denervation (D), arising from significant axonal compromise without evidence of major central nervous system changes; Peripheral Nerve Sensitization (PNS), arising from nerve trunk inflammation without clinical evidence of significant denervation; and Musculoskeletal pain (M), referred from non-neural structures such as the disc or facet joints. The purpose of this study was to investigate the interrater reliability of this classification system. Forty consecutive patients with unilateral low back-related leg pain were independently assessed by five pairs of examiners using a physical examination protocol, screening for central sensitization of the somatosensory system, neurological deficit, and nerve tissue mechano-sensitization. Subjects were classified as follows: CS 30%, D 27.5%, PNS 10%, and M 32.5%. Interrater reliability was good with 80% agreement and a k of 0.72 (95% Confidence Interval (CI) .57-.86). The findings of the study demonstrate that patients with low back-related leg pain can be reliably classified to one of the four proposed groups.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N