Interventions that increase or decrease the likelihood of a meaningful improvement in physical health in patients with sciatica.
OBJECTIVE
The purpose of our study was to determine whether physical therapy interventions predicted meaningful short-term improvement in physical health for patients diagnosed with sciatica.


METHODS
We examined data from 1,804 patients (age: mean=52.1 years, SD=15.6 years; 65.7% female, 34.3% male) who had been diagnosed with sciatica and who had completed an episode of outpatient physical therapy.


METHODS
Principal components factor analysis was used to define intervention categories from specific treatments applied during the plan of care. A nested-model logistic regression analysis identified intervention categories that predicted meaningful improvement in physical health. Meaningful improvement was defined as a change of 14 or more points on the Physical Component Scale-12 (PCS-12) summary score.


RESULTS
Twenty-six percent (n=473) of patients had a meaningful improvement in physical health. Improvement was more likely in patients receiving joint mobility interventions (odds ratio [OR]=2.5, 95% confidence interval [CI]=1.5-4.4) or general exercise (OR=1.5, 95% CI=1.2-2.0). Patients who received spasm reduction interventions were less likely to improve (OR=0.77, 95% CI=0.60-0.98).


CONCLUSIONS
Physical therapists should emphasize the use of joint mobility interventions and exercise when treating patients with sciatica, whereas interventions for spasm reduction should be avoided.
Jewell
Dianne V
DV
Department of Physical Therapy, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, VA 23298-0224, USA. dvjewell@vcu.edu
Riddle
Daniel L
DL
D000203:Activities of Daily Living; D000553:Ambulatory Care / Q000592:standards; D017679:Cryotherapy / Q000592:standards; D004599:Electric Stimulation Therapy / Q000592:standards; D019317:Evidence-Based Medicine; D005081:Exercise Therapy / Q000592:standards; D005163:Factor Analysis, Statistical; D005260:Female; D006304:Health Status; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D016015:Logistic Models; D008297:Male; D008405:Massage / Q000592:standards; D008875:Middle Aged; D010347:Patient Care Planning; D010353:Patient Education as Topic / Q000592:standards; D026741:Physical Therapy Modalities / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards; D011237:Predictive Value of Tests; D012585:Sciatica / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D012720:Severity of Illness Index; D014143:Traction / Q000592:standards; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000592:standards; D014481:United States