title: The centralization phenomenon. Its usefulness as a predictor or outcome in conservative treatment of chronic law back pain (a pilot study).
abstract: METHODS
  Two-hundred-forty-three patients with chronic low back pain were studied in a prospective comparative survey to determine whether the "centralization phenomenon" was associated with outcome after an interdisciplinary work-hardening program.
  
  
  OBJECTIVE
  The hypothesis was that patients who demonstrated centralization during initial mechanical assessment would have better outcomes than noncentralizers.
  
  
  BACKGROUND
  Overall, subjects had decreased pain intensity ratings (mean 20%), increased lifting ability (6-8 kg), and a 59.2% return-to-work rate at a mean of 9.7 months follow-up.
  
  
  METHODS
  Patients were classified as either centralizers or noncentralizers, based on results of their initial assessment. Changes in pain ratings, one-time maximal weights lifted, Oswestry scores, and return-to-work status were compared between groups.
  
  
  RESULTS
  The centralizers reported significant decreases in their maximum pain ratings (centralizers, 16%; noncentralizers, 6%) and had a higher return-to-work rate (centralizers, 68%; noncentralizers, 52%) than the noncentralizers.
  
  
  CONCLUSIONS
  Centralization can help identify sub-groups within the population with chronic low back pain and could be a useful goal setting and case management tool in the rehabilitation of low back pain.
authors.affiliation: Columbia Rehabilitation Centre, Calgary, Alberta, Canada.
authors.forename: A L
authors.initials: AL
authors.lastname: Long
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003710:Demography; D005260:Female; D006801:Humans; D017770:Lifting; D017116:Low Back Pain / Q000175:diagnosis* / Q000534:rehabilitation / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D014937:Work