Manual Therapy
Volume 16, Issue 1 , Pages 3-8 , February 2011

Subgrouping patients with low back pain in primary care: Are we getting any better at it?

Received 19 March 2010 ,Revised 21 May 2010 ,Accepted 27 May 2010.

References 

  1. Assmann SF, Pocock SJ, Enos LE, Kasten LE. Subgroup analysis and other (mis)uses of baseline data in clinical trials. Lancet. 2000;355(9209):1064–1069
  2. Borkan JM, Koes B, Reis S, Cherkin DC. A report from the second international forum for primary care research on low back pain. Reexamining priorities. Spine. 1998;23(18):1992–1996
  3. Bouter LM, Pennick V, Bombardier C, Editorial Board of the Back Review Group . Cochrane back review group. Spine. 2003;28(12):1215–1218
  4. Bouter LM, van Tulder MW, Koes BW. Methodologic issues in low back pain research in primary care. Spine. 1998;23(18):2014–2020
  5. Brennan GP, Fritz JM, Hunter SJ, Thackeray A, Delitto A, Erhard RE. Identifying subgroups of patients with acute/subacute “nonspecific” low back pain: results of a randomized clinical trial. Spine. 2006;31(6):623–631
  6. Brookes ST, Whitely E, Egger M, Smith GD, Mulheran PA, Peters TJ. Subgroup analyses in randomized trials: risks of subgroup-specific analyses; power and sample size for the interaction test. Journal of Clinical Epidemiology. 2004;57(3):229–236
  7. Cairns MC, Foster NE, Wright C. Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain. Spine. 2006;31(19):E670–681
  8. Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, et al. Framework for design and evaluation of complex interventions to improve health. British Medical Journal. 2000;321:694–696
  9. Childs JD, Fritz JM, Flynn TW, Irrgang JJ, Johnson KK, Majkowski GR, et al. A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study. Annals of Internal Medicine. 2004;141(12):920–928
  10. Chou R, Huffman LH, American Pain Society , American College of Physicians . Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Annals of Internal Medicine. 2007;147(7):492–504
  11. Clinical Research Agenda for Physical Therapy. Physical Therapy. 2000;80:499–513
  12. Critchley DJ, Ratcliffe J, Noonan S, Jones RH, Hurley MV. Effectiveness and cost-effectiveness of three types of physiotherapy used to reduce chronic low back pain disability: a pragmatic randomized trial with economic evaluation. Spine. 2007;32(14):1474–1481
  13. Dunn KM, Croft PR. Classification of low back pain in primary care: using “bothersomeness” to identify the most severe cases. Spine. 2005;30:1887–1892
  14. Foster NE, Thompson KA, Baxter GD, Allen JM. Management of nonspecific low back pain by physiotherapists in Britain and Ireland. A descriptive questionnaire of current clinical practice. Spine. 1999;24(13):1332–1342
  15. Foster NE, Dziedzic KS, van der Windt DA, Fritz JM, Hay EM. Research priorities for non-pharmacological therapies for common musculoskeletal problems: nationally and internationally agreed recommendations. BMC Musculoskeletal Disorders. 2009;10:3
  16. Foster N, Mullis R, Lewis M, Main C, Hay E, IMPaCT Back study team . Implementation of subgrouping for targeted treatment systems for low back pain in primary care: a prospective, population-based sequential comparison. In: Proceedings of the international forum X for low back pain research in primary care, Boston, USA, June 14th–17th 2009. 2009;p. 73 http://www.lbpforum.org/program/LBP_Forum_X_Program.pdf[accessed 19.03.10]
  17. Fritz JM, Lindsay W, Matheson JW, Brennan GP, Hunter SJ, Moffit SD, et al. Is there a subgroup of patients with low back pain likely to benefit from mechanical traction? Results of a randomized clinical trial and subgrouping analysis. Spine. 2007;32(26):E793–E800
  18. Fritz JM, Childs JD, Flynn TW. Pragmatic application of a clinical prediction rule in primary care to identify patients with low back pain with a good prognosis following a brief spinal manipulation intervention. BMC Family Practice. 2005;6(1):29
  19. Frost H, Lamb SE, Doll HA, Carver PT, Stewart-Brown S. Randomised controlled trial of physiotherapy compared with advice for low back pain. British Medical Journal. 2004;329(7468):708
  20. Hay EM, Dunn KM, Hill JC, Lewis M, Mason EE, Konstantinou K, et al. A randomised clinical trial of subgrouping and targeted treatment for low back pain compared with best current care. The STarT Back Trial Study Protocol. BMC Musculoskeletal Disorders. 2008;9:58
  21. Hay EM, Mullis R, Lewis M, Vohora K, Main CJ, Watson P, et al. Comparison of physical treatments versus a brief pain-management programme for back pain in primary care: a randomised clinical trial in physiotherapy practice. Lancet. 2005;365(9476):2024–2030
  22. Haldorsen EM, Grasdal AL, Skouen JS, Risa AE, Kronholm K, Ursin H. Is there a right treatment for a particular patient group? Comparison of ordinary treatment, light multidisciplinary treatment, and extensive multidisciplinary treatment for long-term sick-listed employees with musculoskeletal pain. Pain. 2002;95(1–2):49–63
  23. Hancock MJ, Maher CG, Latimer J, Herbert RD, McAuley JH. Independent evaluation of a clinical prediction rule for spinal manipulative therapy: a randomised controlled trial. European Spine Journal. 2008;17(7):936–943
  24. Hancock M, Herbert RD, Maher CG. A guide to interpretation of studies investigating subgroups of responders to physical therapy interventions. Physical Therapy. 2009;89(7):698–704
  25. Henschke N, Maher CG, Refshauge KM, Herbert RD, Cumming RG, Bleasel J, et al. Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study. British Medical Journal. 2008;337:a171
  26. Hill JC, Dunn KM, Lewis M, Mullis R, Main CJ, Foster NE, et al. A primary care back pain screening tool: identifying patient subgroups for initial treatment. Arthritis and Rheumatism. 2008;59(5):632–641
  27. Hill JC, Dunn KM, Main CJ, Hay EM. Subgrouping low back pain: a comparison of the STarT Back Tool with the Orebro Musculoskeletal Pain Screening Questionnaire. European Journal of Pain. 2010;14(1):83–89
  28. Hurley DA, McDonough SM, Dempster M, Moore AP, Baxter GD. A randomized clinical trial of manipulative therapy and interferential therapy for acute low back pain. Spine. 2004;29(20):2207–2216
  29. Johnson RE, Jones GT, Wiles NJ, Chaddock C, Potter RG, Roberts C, et al. Active exercise, education, and cognitive behavioral therapy for persistent disabling low back pain: a randomized controlled trial. Spine. 2007;32(15):1578–1585
  30. Kent P, Keating J. Do primary-care clinicians think that nonspecific low back pain is one condition?. Spine. 2004;29(9):1022–1031
  31. Kent P, Keating JL. Classification in nonspecific low back pain: what methods do primary care clinicians currently use?. Spine. 2005;30(12):1433–1440
  32. Kent P, Mjosund HL, Petersen DHD. Does targeting manual therapy and/or exercise improve patient outcomes in non-specific low back pain? A systematic review. BMC Medicine. 2010;8:22
  33. Lamb SE, Hansen Z, Lall R, et al., on behalf of the Back Skills Training Trial investigators  Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis. Lancet. 2010;Feb 25. [Epub ahead of print]
  34. Linton SJ, Hallden K. Can we screen for problematic back pain? A screening questionnaire for predicting outcome in acute and subacute back pain. Clinical Journal of Pain. 1998;14:209–215
  35. Little P, Lewith G, Webley F, et al. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. British Medical Journal. 2008;337:a884
  36. Long A, Donelson R, Fung T. Does it matter which exercise? A randomized control trial of exercise for low back pain. Spine. 2004;29(23):2593–2602
  37. Luijsterburg PA, Verhagen AP, Ostelo RW, van den Hoogen HJ, Peul WC, Avezaat CJ, et al. Physical therapy plus general practitioners’ care versus general practitioners’ care alone for sciatica: a randomised clinical trial with a 12-month follow-up. European Spine Journal. 2008;17(4):509–517
  38. Macfarlane GJ, Jones GT, Hannaford PC. Managing low back pain presenting to primary care: where do we go from here?. Pain. 2006;122(3):219–222
  39. Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000;84:95–103
  40. May S, Rosedale R. Prescriptive clinical prediction rules in back pain research: a systematic review. Journal of Manual and Manipulative Therapy. 2009;17(1):36–45
  41. McCarthy CJ, Cairns MC. Why is the recent research regarding non-specific pain so non-specific?. Manual Therapy. 2005;10(4):239–241
  42. Rothwell PM. Reliable estimation and interpretation of the effects of treatment in subgroups. In:  Rothwell PM editors. Treating individuals: from randomised trials to personalised medicine. London: Elsevier; 2007;p. 169–182[chapter 11]
  43. Savingy P, Kuntze S, Watson P, Underwood M, Ritchie G, Cotterell M, et al. Low back pain: early management of persistent non-specific low back pain. Full guideline. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners; May 2009;http://www.nice.org.uk/nicemedia/pdf/CG88fullguideline.pdf[accessed 19.03.10]
  44. Smeets RJ, Vlaeyen JW, Hidding A, Kester AD, van der Heijden GJ, Knottnerus JA. Chronic low back pain: physical training, graded activity with problem solving training, or both? The one-year post-treatment results of a randomized controlled trial. Pain. 2008;134(3):263–276
  45. Smeets RJ, Maher CG, Nicholas MK, Refshauge KM, Herbert RD. Do psychological characteristics predict response to exercise and advice for subacute low back pain?. Arthritis and Rheumatism. 2009;61(9):1202–1209
  46. Schmidt CO, Chenot JF, Pfingsten M, Fahland RA, Lindena G, Marnitz U, et al. Assessing a risk tailored intervention to prevent disabling low back pain – protocol of a cluster randomized controlled trial. BMC Musculoskeletal Disorders. 2010;11:5
  47. Underwood MR, Morton V, Farrin A, UK BEAM Trial Team . Do baseline characteristics predict response to treatment for low back pain? Secondary analysis of the UK BEAM dataset. Rheumatology. 2007;46(8):1297–1302
  48. UK Beam Trial Team . United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. British Medical Journal. 2004;329:1377
  49. van der Windt D, Hay EM, Jellema P, Main CJ. Psychosocial interventions for low back pain in primary care: lessons learnt from recent trials. Spine. 2008;33(1):81–89
  50. Van Tulder MW, Koes BW, Bombardier C. Low back pain. Best Practice and Research: Clinical Rheumatology. 2002;16:761–775
  51. van Tulder M, Becker A, Bekkering T, Breen A, del Real MT, Hutchinson A, et al. COST B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care. Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. European Spine Journal. 2006;15(Suppl. 2):S169–S191

PII: S1356-689X(10)00088-3

doi: 10.1016/j.math.2010.05.013

Manual Therapy
Volume 16, Issue 1 , Pages 3-8 , February 2011

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