Centralization in patients with sciatica: are pain responses to repeated movement and positioning associated with outcome or types of disc lesions?

Albert, H; Hauge, Eva; Manniche, Claus

doi:10.1007/s00586-011-2018-9

Cited by 30 publications

(24 citation statements)

References 25 publications

(32 reference statements)

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“…Table shows the main characteristics of the 23 included studies. Of the 14 included cohorts, two were population based (Miranda et al., ; Tubach et al., ), one cohort [three articles (Vroomen et al., , , b)] reported on patients from primary care and 11 cohorts [18 articles (Bush et al., ; Atlas et al., , , , ; Valls et al., ; Edwards et al., ; Jensen et al., ; Karppinen et al., ; Peul et al., , b; Rasmussen et al., ; Freedman et al., ; Olson et al., ; Rihn et al., ; Suri et al., ; Albert et al., ; Jacobsen et al., )] on patients from secondary care. The diagnosis of sciatica in five cohorts was confirmed with diagnostic imaging [nine articles (Karppinen et al., ; Peul et al., , b; Atlas et al., ; Freedman et al., ; Olson et al., ; Rihn et al., ; Suri et al., ; Jacobsen et al., )], seven cohorts based the diagnosis primarily on clinical criteria [12 articles (Bush et al., ; Atlas et al., , , ; Vroomen et al., , , b; Valls et al., ; Edwards et al., ; Jensen et al., ; Rasmussen et al., ; Albert et al., )] and two cohorts on self‐reported presence of back pain radiating to the leg (Miranda et al., ; Tubach et al., ).…”

Section: Resultsmentioning

confidence: 99%

Systematic review of prognostic factors predicting outcome in non‐surgically treated patients with sciatica

Verwoerd

Luijsterburg

Lin

et al. 2013

European Journal of Pain

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Identification of prognostic factors for surgery in patients with sciatica is important to be able to predict surgery in an early stage. Identification of prognostic factors predicting persistent pain, disability and recovery are important for better understanding of the clinical course, to inform patient and physician and support decision making. Consequently, we aimed to systematically review prognostic factors predicting outcome in non-surgically treated patients with sciatica. A search of Medline, Embase, Web of Science and Cinahl, up to March 2012 was performed for prospective cohort studies on prognostic factors for non-surgically treated sciatica. Two reviewers independently selected studies for inclusion and assessed the risk of bias. Outcomes were pain, disability, recovery and surgery. A best evidence synthesis was carried out in order to assess and summarize the data. The initial search yielded 4392 articles of which 23 articles reporting on 14 original cohorts met the inclusion criteria. High clinical, methodological and statistical heterogeneity among studies was found. Reported evidence regarding prognostic factors predicting the outcome in sciatica is limited. The majority of factors that have been evaluated, e.g., age, body mass index, smoking and sensory disturbance, showed no association with outcome. The only positive association with strong evidence was found for leg pain intensity at baseline as prognostic factor for subsequent surgery.

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Section: Resultsmentioning

confidence: 99%

Systematic review of prognostic factors predicting outcome in non‐surgically treated patients with sciatica

Verwoerd

Luijsterburg

Lin

et al. 2013

European Journal of Pain

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“…For a patient with only mid lumbar pain, the pain must cease in order for them to be categorized as a centralizer. However, Albert et al 38 believe that smaller changes in pain location (e.g. distal pain moving proximally from above the ankle to below the knee) must also be recorded as centralization.…”

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confidence: 99%

“…However, it is unclear how long this upright position must be continued and what normally active is. To categorize the patient as a centralizer, Albert et al 38 suggested that the most distal pain must remain abolished for at least 1 minute after positioning the patient in a weightbearing position. It is difficult to compare our inter-rater reliability findings for the category specific exercises with previously conducted studies that investigate the reliability of MDT.…”

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confidence: 99%

Inter-rater reliability of a modified version of Delitto et al.’s classification-based system for low back pain: a pilot study

Apeldoorn

Helvoirt²,

Ostelo

et al. 2016

Journal of Manual & Manipulative Therapy

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Study design: Observational inter-rater reliability study. Objectives: To examine: (1) the inter-rater reliability of a modified version of Delitto et al.'s classificationbased algorithm for patients with low back pain; (2) the influence of different levels of familiarity with the system; and (3) the inter-rater reliability of algorithm decisions in patients who clearly fit into a subgroup (clear classifications) and those who do not (unclear classifications). Methods: Patients were examined twice on the same day by two of three participating physical therapists with different levels of familiarity with the system. Patients were classified into one of four classification groups. Raters were blind to the others' classification decision. In order to quantify the inter-rater reliability, percentages of agreement and Cohen's Kappa were calculated. Results: A total of 36 patients were included (clear classification n523; unclear classification n513). The overall rate of agreement was 53% and the Kappa value was 0.34 [95% confidence interval (CI): 0.11-0.57], which indicated only fair inter-rater reliability. Inter-rater reliability for patients with a clear classification (agreement 52%, Kappa value 0.29) was not higher than for patients with an unclear classification (agreement 54%, Kappa value 0.33). Familiarity with the system (i.e. trained with written instructions and previous research experience with the algorithm) did not improve the inter-rater reliability. Conclusion: Our pilot study challenges the inter-rater reliability of the classification procedure in clinical practice. Therefore, more knowledge is needed about factors that affect the inter-rater reliability, in order to improve the clinical applicability of the classification scheme.

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“…Additionally, this investigation included movement-based physical examination tests commonly used by physical therapists clinically to aid in the assessment and classification of patients with LBP, including symptom peripheralization and/or centralization during lumbar spinal movements in standing. 2,21 These differences in study design and patient population could prove to be clinically meaningful. Patients with sciatica referred to physical therapy may be clinically different from patients referred specifically for EDX testing, particularly if the nature, severity, and/or duration of symptoms influence the medical management of patients with sciatica.…”

Section: T T Conclusionmentioning

confidence: 99%

The Relationship Between History and Physical Examination Findings and the Outcome of Electrodiagnostic Testing in Patients With Sciatica Referred to Physical Therapy

Savage

Fritz

Thackeray

2014

J Orthop Sports Phys Ther

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Centralization in patients with sciatica: are pain responses to repeated movement and positioning associated with outcome or types of disc lesions?

Cited by 30 publications

References 25 publications

Systematic review of prognostic factors predicting outcome in non‐surgically treated patients with sciatica

Systematic review of prognostic factors predicting outcome in non‐surgically treated patients with sciatica

Inter-rater reliability of a modified version of Delitto et al.’s classification-based system for low back pain: a pilot study

The Relationship Between History and Physical Examination Findings and the Outcome of Electrodiagnostic Testing in Patients With Sciatica Referred to Physical Therapy

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