title: A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with mechanical lumbar traction.
abstract: The objective of the study was to develop a clinical prediction rule for identifying patients with low back pain, who improved with mechanical lumbar traction. A prospective, cohort study was conducted in a physiotherapy clinic at a local hospital. Patients with low back pain, referred to physiotherapy were included in the study. The intervention was a standardized mechanical lumbar traction program, which comprised three sessions provided within 9 days. Patient demographic information, standard physical examination, numeric pain scale, fear-avoidance beliefs questionnaire and Oswestry low back pain disability index (pre- and post-intervention) were recorded. A total of 129 patients participated in the study and 25 had positive response to the mechanical lumbar traction. A clinical prediction rule with four variables (non-involvement of manual work, low level fear-avoidance beliefs, no neurological deficit and age above 30 years) was identified. The presence of all four variables (positive likelihood ratio = 9.36) increased the probability of response rate with mechanical lumbar traction from 19.4 to 69.2%. It appears that patients with low back pain who were likely to respond to mechanical lumbar traction may be identified.
authors.affiliation: Rehabilitation Department, Alexandra Hospital, 378 Alexandra Road, Singapore 159964, Singapore. ccongcong@hotmail.com
authors.forename: Congcong
authors.initials: C
authors.lastname: Cai
authors.forename: Yong Hao
authors.initials: YH
authors.lastname: Pua
authors.forename: Kian Chong
authors.initials: KC
authors.lastname: Lim
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D015984:Causality; D015331:Cohort Studies; D003469:Culture; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000145:classification / Q000175:diagnosis* / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010147:Pain Measurement; D018579:Patient Selection; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014143:Traction / Q000592:standards* / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult