Clinical prediction guide
A clinical prediction rule predicted outcome in patients with low back pain having spinal manipulation and exercise treatment
Childs JD, Fritz JM, Flynn TW, et al. A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study. Ann Intern Med 2004;141:920–8.
Q In patients with low back pain (LBP), does a clinical prediction rule predict outcome of spinal manipulation?
Rheumatology
Key Words: exercise therapy • low back pain • manipulation (spinal) • disability evaluation
| The first 150 words of the full text of this article appear below. |
Design:
a randomised controlled trial to validate a previously developed clinical prediction rule for predicting outcome of spinal manipulation.
Setting:
8 physical therapy clinics in 2 academic medical centres and outpatient practice settings in the US.
Patients:
131 patients who were 18–60 years of age (mean age 34 y, 58% men), had a primary symptom of LBP, were referred to physical therapy, and had an Oswestry Disability Questionnaire (ODQ) score 
30%. Exclusion criteria: serious spinal condition, nerve root compression, pregnancy, or previous surgery to the lumbosacral spine or pelvis. Patients were allocated to receive spinal manipulation plus exercise (n = 70) or exercise alone (n = 61) given by a physical therapist for 4 weeks.
Description of prediction guide:
the clinical prediction rule criteria were (1) LBP symptom duration <16 days, (2) no symptoms distal to the knee, (3) Fear Avoidance Beliefs Questionnaire work subscale score <19 points, (4) 1
Barts and The London
London, UK
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