PMID- 26890953
OWN - NLM
STAT- MEDLINE
DCOM- 20170518
LR  - 20210113
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 41
IP  - 16
DP  - 2016 Aug 15
TI  - How Effective is Physical Therapy for Common Low Back Pain Diagnoses?: A 
      Multivariate Analysis of 4597 Patients.
PG  - 1325-1329
LID - 10.1097/BRS.0000000000001506 [doi]
AB  - STUDY DESIGN: A retrospective review. OBJECTIVE: The aim of this study is to 
      evaluate whether the treatment of low back pain with physical therapy results in 
      clinically significant improvements in patient-reported pain and functional 
      outcomes. SUMMARY OF BACKGROUND DATA: Low back pain is a major cause of morbidity 
      and disability in health care. Previous studies have found poor efficacy for 
      surgery in the absence of specific indications. A variety of nonoperative 
      treatments are available; however, there is scant evidence to guide the 
      practitioner as to the efficacy of these treatments. METHODS: Four thousand five 
      hundred ninety-seven patients who underwent physical therapy for the nonoperative 
      treatment of low back pain were included. The primary outcome measures were 
      pre-and post-treatment scores on the Oswestry Disability Index (ODI), Numeric 
      Pain Rating Scale (NPRS) during activity, and NPRS during rest. Previously 
      published thresholds for minimal clinically important difference (MCID) were used 
      to determine the proportion of patients meeting MCID for each of our outcomes. 
      Patients with starting values below the MCID for each variable were excluded from 
      analysis. Logistic regression analysis was used to determine patient risk factors 
      predictive of treatment failure. RESULTS: About 28.5% of patients met the MCID 
      for improvement in ODI. Presence of night symptoms, obesity, and smoking were 
      predictors of treatment failure for ODI. Fifty-nine percent of patients met the 
      MCID for improvement in resting NPRS, with a history of venous thromboembolism, 
      night symptoms, psychiatric disease, workers' compensation status, smoking, and 
      obesity predictive of treatment failure. Sixty percent of patients met the MCID 
      for improvement in activity NPRS, with night symptoms, workers' compensation 
      status, and smoking predictive of treatment failure. CONCLUSION: We observed that 
      a substantial percentage of the population did not meet MCID for pain and 
      function following treatment of low back pain with physical therapy. Common risk 
      factors for treatment failure included smoking and presence of night symptoms. 
      LEVEL OF EVIDENCE: 4.
FAU - Eleswarapu, Ananth S
AU  - Eleswarapu AS
AD  - University of Chicago Medical Center, Chicago, IL.
FAU - Divi, Srikanth N
AU  - Divi SN
AD  - University of Chicago Medical Center, Chicago, IL.
FAU - Dirschl, Douglas R
AU  - Dirschl DR
AD  - University of Chicago Medical Center, Chicago, IL.
FAU - Mok, James M
AU  - Mok JM
AD  - University of Chicago Medical Center, Chicago, IL.
FAU - Stout, Christopher
AU  - Stout C
AD  - ATI, Bolingbrook, IL.
AD  - University of Illinois at Chicago, College of Medicine, Chicago, IL.
FAU - Lee, Michael J
AU  - Lee MJ
AD  - University of Chicago Medical Center, Chicago, IL.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Disability Evaluation
MH  - Female
MH  - Humans
MH  - Low Back Pain/*diagnosis/*therapy
MH  - Male
MH  - Multivariate Analysis
MH  - Pain Measurement/methods
MH  - Patient Satisfaction/statistics & numerical data
MH  - Physical Therapy Modalities
MH  - Retrospective Studies
MH  - Spinal Fusion/methods
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
EDAT- 2016/02/19 06:00
MHDA- 2017/05/19 06:00
CRDT- 2016/02/19 06:00
PHST- 2016/02/19 06:00 [entrez]
PHST- 2016/02/19 06:00 [pubmed]
PHST- 2017/05/19 06:00 [medline]
AID - 00007632-201608150-00016 [pii]
AID - 10.1097/BRS.0000000000001506 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2016 Aug 15;41(16):1325-1329. doi: 
      10.1097/BRS.0000000000001506.