title: Value of predictive instruments to determine persisting restriction of function in patients with subacute non-specific low back pain. Systematic review.
abstract: Low back pain (LBP) can restrict function with all the personal, interpersonal, and social consequences, such as a loss of independence and the inability to fulfil diverse roles in social life. Therefore, the prevention of the consequences of LBP would reduce costs, individual burdens and social burdens. Being able to fulfil the requirements of daily living is a cornerstone of quality of life. Early identification of patients who are likely to develop chronic pain with persistent restricted function is important, as effective prevention needs informed allocation of health care and social work. The aim of this study was to report and discuss the predictive value of instruments used to identify patients at risk of chronic LBP. Medline, Embase, CINAHL, Central, PEDro, Psyndex, PsychInfo/PsycLit, and Sociofile were systematically searched up to July 2004. Reference lists of systematic reviews on risk factors, and reference lists of the studies included were also searched. The selected studies evaluated predictive values of tools or predictive models applied 2-12 weeks after an initial medical consultation for a first or a new episode of non-specific LBP with restriction in function. Instruments had to predict function-related outcomes. Because of the heterogeneity of the instruments used we did not pool the data. Sixteen publications on function-related outcomes were included. The predictive instruments in these studies showed only moderate ability to predict or explain function-related outcome (maximal 51% of the variability). There was great variability in the predictors included and not all known risk factors were included in the models. The reviewed tools showed a limited ability to predict function-related outcome in patients with risk of chronic low back pain. Future instruments should be based on models with a comprehensive set of known risk factors. These models should be constructed and validated by international, coordinated research teams.
authors: Domain Health and Social Work, Physiotherapy, University of Applied Sciences Western Switzerland, Valais, Leukerbad, Switzerland. roger.hilfiker@hevs.ch
authors: Roger
authors: R
authors: Hilfiker
authors: Lucas M
authors: LM
authors: Bachmann
authors: Carolin A-M
authors: CA
authors: Heitz
authors: Tobias
authors: T
authors: Lorenz
authors: Harri
authors: H
authors: Joronen
authors: Andreas
authors: A
authors: Klipstein
mesh_terms: D000208:Acute Disease; D016206:Databases, Bibliographic / Q000592:standards; D004185:Disability Evaluation; D006801:Humans; D017116:Low Back Pain / Q000473:pathology*; D016017:Odds Ratio
references: Eur Spine J. 2006 Mar;15 Suppl 2:S136-68
references: 16550446
references: J Epidemiol Community Health. 1998 Jun;52(6):377-84
references: 9764259
references: Stat Med. 2004 Dec 30;23(24):3729-53
references: 15580598
references: BMJ. 2001 Sep 22;323(7314):681-4
references: 11566835
references: Clin Biomech (Bristol, Avon). 2000 Jul;15(6):389-406
references: 10771118
references: Stat Med. 2000 Feb 29;19(4):453-73
references: 10694730
references: Eur Spine J. 2006 Mar;15 Suppl 2:S169-91
references: 16550447
references: Spine (Phila Pa 1976). 2002 Apr 15;27(8):851-7
references: 11935108
references: BMJ. 2001 Jul 14;323(7304):101-5
references: 11451790
references: Spine (Phila Pa 1976). 1999 Aug 1;24(15):1556-61
references: 10457575
references: Spine (Phila Pa 1976). 2000 Jan;25(1):115-20
references: 10647169
references: Br J Cancer. 1994 Jun;69(6):979-85
references: 8198989
references: JAMA. 1997 Feb 12;277(6):488-94
references: 9020274
references: J Occup Rehabil. 2001 Mar;11(1):53-66
references: 11706777
references: Spine (Phila Pa 1976). 1995 Feb 15;20(4):478-84
references: 7747233
references: Spine (Phila Pa 1976). 1993 Jun 1;18(7):855-62
references: 8316884
references: Ann Intern Med. 1999 Mar 16;130(6):515-24
references: 10075620
references: BMJ. 2003 Aug 9;327(7410):323
references: 12907487
references: J Occup Rehabil. 2002 Dec;12(4):277-95
references: 12389479
references: Spine (Phila Pa 1976). 2000 Dec 1;25(23):3055-64
references: 11145817
references: Scand J Work Environ Health. 2004 Feb;30(1):47-55
references: 15018028
references: Clin J Pain. 2001 Dec;17(4 Suppl):S39-45
references: 11783830
references: Arch Phys Med Rehabil. 1998 Apr;79(4):366-74
references: 9552100
references: Disabil Rehabil. 2001 Dec 15;23(18):815-28
references: 11763278
references: Occup Environ Med. 2004 Jan;61(1):e2
references: 14691283
references: Occup Environ Med. 2002 Jul;59(7):459-65
references: 12107294
references: Scand J Work Environ Health. 1999 Feb;25(1):50-6
references: 10204671
references: J Clin Epidemiol. 2005 May;58(5):475-83
references: 15845334
references: Ann Intern Med. 1993 Feb 1;118(3):201-10
references: 8417638
references: Pain. 2005 Aug;116(3):205-212
references: 15927382
references: Health Psychol. 1998 Sep;17(5):421-7
references: 9776000
references: J Clin Epidemiol. 2005 Jul;58(7):714-8
references: 15939223
references: Breast Cancer Res Treat. 1998;52(1-3):289-303
references: 10066088
references: Pain. 2005 Oct;117(3):304-313
references: 16153772
references: Rheumatology (Oxford). 2001 Jul;40(7):772-8
references: 11477282
references: Spine (Phila Pa 1976). 2003 Dec 1;28(23):2634-40
references: 14652481
references: Int J Rehabil Res. 1998 Mar;21(1):29-40
references: 9924664
references: Occup Environ Med. 2003 Sep;60(9):618-26
references: 12937181
references: Pain. 1997 Nov;73(2):213-221
references: 9415508
references: Rev Rhum Engl Ed. 1997 Mar;64(3):189-94
references: 9090769
references: J Clin Epidemiol. 1997 Jan;50(1):31-43
references: 9048688