title: Children and adolescents with low back pain: a descriptive study of physical examination and outcome measurement.
abstract: METHODS
  A retrospective, cohort study of children and adolescents with low back pain (LBP) referred to physical therapy.
  
  
  OBJECTIVE
  To describe the clinical presentation, examination findings, and classification of children and adolescent patients with LBP, and to explore the concurrent validity of the Oswestry questionnaire as a disability measure in this group.
  
  
  BACKGROUND
  Little information is available regarding the clinical presentation, physical examination findings, and outcome assessment in children and adolescents with LOP.
  
  
  METHODS
  Charts were reviewed for historical, diagnostic, physical examination,and outcome information. Diagnoses given by the referring physicians were recorded. A treatment-based classification was made for each subject. Descriptive statistics were calculated for all variables. The validity of the Oswestry questionnaire was examined.
  
  
  RESULTS
  The children and adolescents included in this study represented 5% (n = 25) of all cases of LOP referred to physical therapy. A greater percentage of patients had difficulty with extension than with flexion range of motion (ROM). Initial pain scores were lower if a specific pathology was present (P = .001). Initial pain and Oswestry scores were poorly correlated (r = 0.16). Forty-four percent (n = 11) of patients scored under the floor value of 12% on the Oswestry.
  
  
  CONCLUSIONS
  The referral rate of children and adolescents with LBP seems to be low. Compared to adults, children and adolescents appear more likely to have a specific diagnosis given to them by their physician. The physical examination findings appear to indicate that spinal stabilization approaches may be beneficial for many patients. The Oswestry questionnaire may not be a valid tool for documenting changes in disability in these patients. Further research is needed on the conservative management of children and adolescents with LBP.
authors.affiliation: School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA. sncst16@pitt.edu
authors.forename: Shannon N
authors.initials: SN
authors.lastname: Clifford
authors.forename: Julie M
authors.initials: JM
authors.lastname: Fritz
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D019988:Children with Disabilities / Q000145:classification*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000145:classification* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008499:Medical Records; D010808:Physical Examination; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome