PMID- 21411824
OWN - NLM
STAT- MEDLINE
DCOM- 20110531
LR  - 20220410
IS  - 1056-6716 (Print)
IS  - 1056-6716 (Linking)
VI  - 20
IP  - 1
DP  - 2011 Feb
TI  - Clinical assessment of low-back-pain treatment outcomes in athletes.
PG  - 74-88
AB  - PATIENT SCENARIO: A 21-year-old male rodeo athlete complains of acute low back 
      pain (LBP) after a bareback event. The athlete wishes to compete in a rodeo event 
      in 4 d. CLINICAL OUTCOMES ASSESSMENT: Given the questionable validity and 
      reliability of traditional clinical examination techniques for LBP, a treatment 
      subgroup classification system combined with clinical outcomes assessment 
      provides greater insight into suitable clinical interventions and patient 
      response to treatment. Four LBP treatment subgroups based on the patient's 
      clinical presentation and symptoms have been established: manipulation, 
      stabilization, specific exercise, and traction. Manipulation subgroup research 
      has produced a valid clinical prediction rule (CPR). The Visual Analog Scale, 
      Numeric Rating Scale (NRS), Oswestry Low Back Pain Disability Index (ODI), Roland 
      Morris Disability Questionnaire, Short Form 36 (SF-36), and Global Rating of 
      Change Scale are valid, reliable, and responsive outcomes instruments with 
      established values for minimum clinically important difference (MCID). These 
      instruments document important changes in disablement and health-related quality 
      of life in patients with low back injury, as well as demonstrate treatment 
      outcomes. CLINICAL DECISION MAKING: On examination the athlete presents with 
      moderate pain and disability as measured by the NRS, ODI, and SF-36 and meets all 
      5 criteria for the manipulation subgroup, indicating a high likelihood of success 
      with manipulative therapy when following the guidelines presented in the CPR. 
      Expected outcomes values, based on MCID values, were met after 1 treatment. 
      Preferred outcomes, based on physical activity requirements for sport, were met 
      on day 4. CLINICAL BOTTOM LINE: LBP generators are difficult to establish using 
      traditional clinical examination techniques. The combined use of clinical 
      criteria, using an LBP subgroup system, and baseline outcomes measures should 
      guide treatment. Benchmarks should be guided by established MCID values for each 
      instrument.
FAU - Vela, Luzita I
AU  - Vela LI
AD  - Dept of Health and Human Performance, Texas State University, San Marcos, TX, 
      USA.
FAU - Haladay, Douglas E
AU  - Haladay DE
FAU - Denegar, Craig
AU  - Denegar C
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Sport Rehabil
JT  - Journal of sport rehabilitation
JID - 9206500
SB  - IM
MH  - Adult
MH  - Athletic Injuries/classification/diagnosis/*rehabilitation
MH  - Decision Making
MH  - Disability Evaluation
MH  - Health Status Indicators
MH  - Humans
MH  - Low Back Pain/classification/diagnosis/*rehabilitation
MH  - Male
MH  - Outcome Assessment, Health Care/*methods
MH  - Pain Measurement/methods
MH  - Quality of Life
MH  - *Surveys and Questionnaires
MH  - Young Adult
EDAT- 2011/03/18 06:00
MHDA- 2011/06/01 06:00
CRDT- 2011/03/18 06:00
PHST- 2011/03/18 06:00 [entrez]
PHST- 2011/03/18 06:00 [pubmed]
PHST- 2011/06/01 06:00 [medline]
AID - 10.1123/jsr.20.1.74 [doi]
PST - ppublish
SO  - J Sport Rehabil. 2011 Feb;20(1):74-88. doi: 10.1123/jsr.20.1.74.