Does a Diagnostic Classification Algorithm Help to Predict the Course of Low Back Pain? A Study of Danish Chiropractic Patients With 1-Year Follow-up.

BACKGROUND: A diagnostic classification algorithm, "the Petersen classification," consisting of 12 categories based on a standardized examination protocol, was developed for the primary purpose of identifying clinically homogeneous subgroups of individuals with low back pain (LBP), OBJECTIVES: To in...

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Publicado en:Journal of Orthopaedic & Sports Physical Therapy Vol. 48; no. 11; pp. 837 - 847
Autores principales: HARTVIGSEN, LISBETH, KONGSTED, ALICE, VACH, WERNER, SALMI, LOUIS-RACHID, HESTBAEK, LISE
Formato: research tables/charts Journal Article
Publicado: JOSPT, Inc. d/b/a Movement Science Media Nov2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2018
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      pub: JOSPT, Inc. d/b/a Movement Science Media
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        10.2519/jospt.2018.8083
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        atl: Does a Diagnostic Classification Algorithm Help to Predict the Course of Low Back Pain? A Study of Danish Chiropractic Patients With 1-Year Follow-up.
      aug:
        au:
          HARTVIGSEN, LISBETH
          KONGSTED, ALICE
          VACH, WERNER
          SALMI, LOUIS-RACHID
          HESTBAEK, LISE
        affil: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
      sug:
        subj:
          Algorithms Evaluation
          Low Back Pain Epidemiology
          Low Back Pain Physiopathology
          Outcome Assessment
          Patients
          Chiropractic Practice
          Human
          Male
          Female
          Adult
          Middle Age
          Prospective Studies
          Observational Methods
          Linear Regression
          Logistic Regression
          Confidence Intervals
          Data Analysis
          Questionnaires
          Scales
          Denmark
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: BACKGROUND: A diagnostic classification algorithm, "the Petersen classification," consisting of 12 categories based on a standardized examination protocol, was developed for the primary purpose of identifying clinically homogeneous subgroups of individuals with low back pain (LBP), OBJECTIVES: To investigate whether a diagnostic classification algorithm is associated with activity limitation and LBP intensity at follow-up assessments of 2 weeks, 3 months, and 1 year, and whether the algorithm improves outcome prediction when added to a set of known predictors. METHODS: This was a prospective observational study of 934 consecutive adult patients with new episodes of LBP who were visiting chiropractic practices in primary care and categorized according to the Petersen classification. Outcomes were disability and pain intensity measured with questionnaires at 2 weeks and 3 months, and 1-year trajectories of LBP based on weekly responses to text messages. Associations were analyzed with linear and logistic regression models. In a subgroup of patients, the numbers of visits to primary and secondary care were described. RESULTS: The Petersen classification was statistically significantly associated with all outcomes (P<.001) but explained very little of the variance (R² = 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 in 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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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