Knee

Cleland, Joshua A.; Koppenhaver, Shane

doi:10.1016/b978-1-4377-1384-8.00016-x

Cited by 1 publication

(2 citation statements)

References 66 publications

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“…It is to be noted that these findings were established for a 50% improvement on the ODI and different variables would likely have been obtained had a different ODI threshold or other outcomes been used. Furthermore, the LR+ (3.9) and LR- (0.28) were relatively low [ 35 ], suggesting that the predictive capability of the model is limited. In comparison, Hicks et al [ 15 ] found similar LR+ (LR+ 4.0), but higher LR- (LR- 0.18), with their preliminary CPR.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic factors of a favorable outcome following a supervised exercise program for soldiers with sub-acute and chronic low back pain

Perron

Gendron

Langevin

et al. 2018

BMC Musculoskelet Disord

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BackgroundLow back pain (LBP) encompasses heterogeneous patients unlikely to respond to a unique treatment. Identifying sub-groups of LBP may help to improve treatment outcomes. This is a hypothesis-setting study designed to create a clinical prediction rule (CPR) that will predict favorable outcomes in soldiers with sub-acute and chronic LBP participating in a multi-station exercise program.MethodsMilitary members with LBP participated in a supervised program comprising 7 stations each consisting of exercises of increasing difficulty. Demographic, impairment and disability data were collected at baseline. The modified Oswestry Disability Index (ODI) was administered at baseline and following the 6-week program. An improvement of 50% in the initial ODI score was considered the reference standard to determine a favorable outcome. Univariate associations with favorable outcome were tested using chi-square or paired t-tests. Variables that showed between-group (favorable/unfavorable) differences were entered into a logistic regression after determining the sampling adequacy. Finally, continuous variables were dichotomized and the sensitivity, specificity and positive and negative likelihood ratios were determined for the model and for each variable.ResultsA sample of 85 participants was included in analyses. Five variables contributed to prediction of a favorable outcome: no pain in lying down (p = 0.017), no use of antidepressants (p = 0.061), FABQ work score < 22.5 (p = 0.061), fewer than 5 physiotherapy sessions before entering the program (p = 0.144) and less than 6 months’ work restriction (p = 0.161). This model yielded a sensitivity of 0.78, specificity of 0.80, LR+ of 3.88, and LR- of 0.28. A 77.5% probability of favorable outcome can be predicted by the presence of more than three of the five variables, while an 80% probability of unfavorable outcome can be expected if only three or fewer variables are present.ConclusionThe use of prognostic factors may guide clinicians in identifying soldiers with LBP most likely to have a favorable outcome. Further validation studies are needed to determine if the variables identified in our study are treatment effect modifiers that can predict success following participation in the multi-station exercise program.Trial registrationClinicalTrials.gov Identifier: NCT03464877 registered retrospectively on 14 March 2018.Electronic supplementary materialThe online version of this article (10.1186/s12891-018-2022-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…The single inclinometer method was used to measure trunk extension (ICC = 0.61–0.95) [ 34 ]. Passive hip ROM was measured bilaterally using a goniometer or an inclinometer (ICC = 0.56–0.99) [ 35 ] and included internal rotation, external rotation, flexion and extension.…”

Section: Methodsmentioning

confidence: 99%