Predicting response to motor control exercises and graded activity for patients with low back pain: preplanned secondary analysis of a randomized controlled trial.

Abstract:

BACKGROUND:Current treatments for low back pain have small effects. A research priority is to identify patient characteristics associated with larger effects for specific interventions. OBJECTIVE:The aim of this study was to identify simple clinical characteristics of patients with chronic low back pain who would benefit more from either motor control exercises or graded activity. DESIGN:This study was a secondary analysis of the results of a randomized controlled trial. METHODS:One hundred seventy-two patients with chronic low back pain were enrolled in the trial, which was conducted in Australian physical therapy clinics. The treatment consisted of 12 initial exercise sessions over an 8-week period and booster sessions at 4 and 10 months following randomization. The putative effect modifiers (psychosocial features, physical activity level, walking tolerance, and self-reported signs of clinical instability) were measured at baseline. Measures of pain and function (both measured on a 0-10 scale) were taken at baseline and at 2, 6, and 12 months by a blinded assessor. RESULTS:Self-reported clinical instability was a statistically significant and clinically important modifier of treatment response for 12-month function (interaction: 2.72; 95% confidence interval=1.39 to 4.06). Participants with high scores on the clinical instability questionnaire (≥9) did 0.76 points better with motor control exercises, whereas those who had low scores (<9) did 1.93 points better with graded activity. Most other effect modifiers investigated did not appear to be useful in identifying preferential response to exercise type. LIMITATIONS:The psychometric properties of the instability questionnaire have not been fully tested. CONCLUSIONS:A simple 15-item questionnaire of features considered indicative of clinical instability can identify patients who respond best to either motor control exercises or graded activity.

journal_name

Phys Ther

journal_title

Physical therapy

authors

Macedo LG,Maher CG,Hancock MJ,Kamper SJ,McAuley JH,Stanton TR,Stafford R,Hodges PW

doi

10.2522/ptj.20140014

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

1543-54

issue

11

eissn

0031-9023

issn

1538-6724

pii

ptj.20140014

journal_volume

94

pub_type

杂志文章,随机对照试验
  • Physical Activity and Exercise Outcomes in Huntington Disease (PACE-HD): Protocol for a 12-Month Trial Within Cohort Evaluation of a Physical Activity Intervention in People With Huntington Disease.

    abstract:BACKGROUND:Exercise is emerging as an important aspect in the management of disease-related symptoms and functional decline in people with Huntington disease (HD). Long-term evaluation of physical activity and exercise participation in HD has yet to be undertaken. OBJECTIVE:The objective is to investigate the feasibil...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/pzz075

    authors: Drew CJG,Quinn L,Hamana K,Williams-Thomas R,Marsh L,Dimitropoulou P,Playle R,Griffin BA,Kelson M,Schubert R,Muratori L,Reilmann R,Rosser A,Busse M

    更新日期:2019-09-01 00:00:00

  • McConnell taping shifts the patella inferiorly in patients with patellofemoral pain: a dynamic magnetic resonance imaging study.

    abstract:BACKGROUND:Patellar taping is widely used clinically to treat patients with patellofemoral pain syndrome (PFPS). Although patellar taping has been demonstrated to reduce patellofemoral pain in patients with PFPS, the kinematic source for this pain reduction has not been identified. OBJECTIVE:The purpose of this study ...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.2522/ptj.20080365

    authors: Derasari A,Brindle TJ,Alter KE,Sheehan FT

    更新日期:2010-03-01 00:00:00

  • Teaching human anatomy in physical therapy education in the United States: a survey.

    abstract:BACKGROUND AND PURPOSE:The purpose of this study was to determine how human anatomy was being taught in physical therapy programs in the United States. SUBJECTS:Faculty in 103 physical therapy programs participated in the study. METHODS:A six-page questionnaire, which was mailed to 145 physical therapy programs, cont...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/74.8.720

    authors: Mattingly GE,Barnes CE

    更新日期:1994-08-01 00:00:00

  • Otago Exercise Program in the United States: Comparison of 2 Implementation Models.

    abstract:Background:The Otago Exercise Program (OEP) is an evidence-based fall prevention program delivered by a physical therapist in 6 visits over a year. Despite documented effectiveness, there has been limited adoption of the OEP by physical therapists in the United States. To facilitate dissemination, 2 models have been de...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.2522/ptj.20160236

    authors: Shubert TE,Smith ML,Goto L,Jiang L,Ory MG

    更新日期:2017-02-01 00:00:00

  • Pelvic-floor rehabilitation, Part 2: Pelvic-floor reeducation with interferential currents and exercise in the treatment of genuine stress incontinence in postpartum women--a cohort study.

    abstract:BACKGROUND AND PURPOSE:This descriptive cohort study investigated a physical therapy program of pelvic-floor neuromuscular electrostimulation (NMES) combined with exercises, with the aim of developing a simple, inexpensive, and conservative treatment for postpartum genuine stress incontinence (GSI). SUBJECTS:Eight fem...

    journal_title:Physical therapy

    pub_type: 临床试验,杂志文章

    doi:10.1093/ptj/75.12.1075

    authors: Dumoulin C,Seaborne DE,Quirion-DeGirardi C,Sullivan SJ

    更新日期:1995-12-01 00:00:00

  • The novice versus the experienced clinician: insights into the work of the physical therapist.

    abstract::The purpose of this study was to develop a conceptual framework and a data-collection tool to begin a systematic analysis of the work of the physical therapist. The primary method of data collection was nonparticipant observation of physical therapist-patient treatment sessions. A team of two researchers performed eac...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/70.5.314

    authors: Jensen GM,Shepard KF,Hack LM

    更新日期:1990-05-01 00:00:00

  • Rehabilitation for balance and ambulation in a patient with attention impairment due to intracranial hemorrhage.

    abstract:BACKGROUND AND PURPOSE:The purpose of this case report is to describe physical therapy to improve the balance and ambulation of a 16-year-old patient with attention impairment following intracranial hemorrhage. CASE DESCRIPTION:The patient initially had frequent losses of balance, especially in distracting environment...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:

    authors: Tappan RS

    更新日期:2002-05-01 00:00:00

  • Correlation of 3-dimensional shoulder kinematics to function in subjects with idiopathic loss of shoulder range of motion.

    abstract:BACKGROUND AND PURPOSE:People with idiopathic loss of shoulder range of motion (ROM) have difficulty completing activities of daily living. This investigation was performed to determine the association between active glenohumeral ROM and function and to develop a multiple regression equation to explain variation in fun...

    journal_title:Physical therapy

    pub_type: 临床试验,杂志文章

    doi:

    authors: Rundquist PJ,Ludewig PM

    更新日期:2005-07-01 00:00:00

  • Utilization of physical therapy personnel in one hospital. A work sampling study.

    abstract::The purpose of this study was to illustrate the adaptability and use of work sampling, an industrial engineering technique, as a dependable method for collecting personnel utilization data in the physical therapy department of a general hospital and to demonstrate the concept of work sampling to physical therapy super...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/63.7.1108

    authors: Domenech MA,Payton O,Hill J,Shukla RK

    更新日期:1983-07-01 00:00:00

  • Benchmarking the Physical Therapist Academic Environment to Understand the Student Experience.

    abstract:Background:Identifying excellence in physical therapist academic environments is complicated by the lack of nationally available benchmarking data. Objective:The objective of this study was to compare a physical therapist academic environment to another health care profession (medicine) academic environment using the ...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/pzy051

    authors: Shields RK,Dudley-Javoroski S,Sass KJ,Becker M

    更新日期:2018-08-01 00:00:00

  • Implementation of the problem-oriented progress note in a skilled nursing facility.

    abstract::Problem-oriented style progress notes were implemented in a skilled nursing facility where problem-oriented medical records were not in use. The problem-oriented note consists of subjective information, objective information, analysis or assessment of the problems, and plan for treatment, and is called a SOAP note. Si...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/59.2.160

    authors: Shaughnessy MK,Burnett CN

    更新日期:1979-02-01 00:00:00

  • Psychologically informed interventions for low back pain: an update for physical therapists.

    abstract::A central theme of current evidence-based guidelines for managing low back pain is endorsement of the resumption of activities despite the presence of pain. This task can be challenging for both therapists and patients, and there are many essentially psychological obstacles to implementing the guidelines. These obstac...

    journal_title:Physical therapy

    pub_type: 杂志文章,评审

    doi:10.2522/ptj.20100278

    authors: Nicholas MK,George SZ

    更新日期:2011-05-01 00:00:00

  • Quantitative gait evaluation in the clinic.

    abstract::The purpose of this paper is to present a clinically feasible method to provide objective, quantitative information regarding the quality of a patient's gait. The technique used is simple and economical and requires minimal equipment. The four basic temporal and distance factors are 1) stride length, 2) step length, 3...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/61.3.351

    authors: Robinson JL,Smidt GL

    更新日期:1981-03-01 00:00:00

  • Transcutaneous electrical nerve stimulation characteristics for altering pain perception.

    abstract::The purpose of this study was to determine the effect of conventional low-intensity transcutaneous electrical nerve stimulation (TENS) waveform and frequency characteristics on experimentally induced acute pain. Each of 28 male subjects received six forms of TENS and one control treatment during a single testing sessi...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/66.10.1515

    authors: Barr JO,Nielsen DH,Soderberg GL

    更新日期:1986-10-01 00:00:00

  • Force-time measurements of knee muscle functions of subjects with multiple sclerosis.

    abstract::The purpose of this study was to determine whether the time-rate of muscle tension development, the muscle tension-maintaining capacity, and the reciprocal inhibition time of muscles in subjects with multiple sclerosis were significantly different from those of healthy subjects. An isokinetic dynamometer was used to e...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/67.6.934

    authors: Chen WY,Pierson FM,Burnett CN

    更新日期:1987-06-01 00:00:00

  • Psychometric properties of the Dutch Chronic Fatigue Syndrome--Activities and Participation Questionnaire (CFS-APQ).

    abstract:BACKGROUND AND PURPOSE:The Chronic Fatigue Syndrome-Activities and Participation Questionnaire (CFS-APQ) is a recently developed disease-specific assessment tool for monitoring activity limitations and participation restrictions in patients with chronic fatigue syndrome (CFS). In this study, the convergent validity, co...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:

    authors: Nijs J,Vaes P,McGregor N,Van Hoof E,De Meirleir K

    更新日期:2003-05-01 00:00:00

  • Clinical decision making by experienced and inexperienced pediatric physical therapists for children with diplegic cerebral palsy.

    abstract:BACKGROUND AND PURPOSE:This qualitative study was designed to explore, identify, and describe clinical decision-making processes used by pediatric physical therapists. SUBJECTS:Clinical decision-making processes of three experienced therapists and three inexperienced therapists were assessed as they worked with 18 chi...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/76.1.20

    authors: Embrey DG,Guthrie MR,White OR,Dietz J

    更新日期:1996-01-01 00:00:00

  • Impairment-based examination and disability management of an elderly woman with sacroiliac region pain.

    abstract:BACKGROUND AND PURPOSE:The purpose of this case report is to describe the use of a cluster of sacroiliac tests in conjunction with an impairment-based model of examination, diagnosis, and management of sacroiliac region pain. CASE DESCRIPTION:The patient was a 74-year-old woman with an 18-month history of low back, le...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:

    authors: Godges JJ,Varnum DR,Sanders KM

    更新日期:2002-08-01 00:00:00

  • Assessing longitudinal change in coordination of the paretic upper limb using on-site 3-dimensional kinematic measurements.

    abstract:BACKGROUND AND PURPOSE:It is largely unknown how adaptive motor control of the paretic upper limb contributes to functional recovery after stroke. This paucity of knowledge emphasizes the need for longitudinal 3-dimensional (3D) kinematic studies with frequent measurements to establish changes in coordination after str...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.2522/ptj.20100341

    authors: van Kordelaar J,van Wegen EE,Nijland RH,de Groot JH,Meskers CG,Harlaar J,Kwakkel G

    更新日期:2012-01-01 00:00:00

  • Reliability of impairment and physical performance measures for persons with Parkinson's disease.

    abstract:BACKGROUND AND PURPOSE:Parkinson's disease (PD) is characterized by rigidity, postural instability, bradykinesia, and tremor, as well as other musculoskeletal impairments and functional limitations. The purpose of this investigation was to determine the reliability and stability of measures of impairments and physical ...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/77.1.19

    authors: Schenkman M,Cutson TM,Kuchibhatla M,Chandler J,Pieper C

    更新日期:1997-01-01 00:00:00

  • Effectiveness and Cost-Effectiveness of Different Weekly Frequencies of Pilates for Chronic Low Back Pain: Randomized Controlled Trial.

    abstract:BACKGROUND:The Pilates method has been recommended to patients with low back pain, but the evidence on effectiveness is inconclusive. In addition, there is still no evidence for the cost-effectiveness of this method or for the ideal number of sessions to achieve the highest effectiveness. OBJECTIVE:The aim of this stu...

    journal_title:Physical therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.2522/ptj.20150404

    authors: Miyamoto GC,Moura KF,Franco YR,Oliveira NT,Amaral DD,Branco AN,Silva ML,Lin C,Cabral CM

    更新日期:2016-03-01 00:00:00

  • Physical therapists' management of patients in the acute care setting: an observational study.

    abstract:BACKGROUND:Previous literature has not fully described physical therapists' management of patients across diagnoses in the acute care setting or how that management might vary by facility. OBJECTIVE:The purposes of this study were to describe patient management by physical therapists in the acute care setting and to e...

    journal_title:Physical therapy

    pub_type: 杂志文章,多中心研究

    doi:10.2522/ptj.20080338

    authors: Jette DU,Brown R,Collette N,Friant W,Graves L

    更新日期:2009-11-01 00:00:00

  • Are teaching principles associated with improved motor performance in children with developmental coordination disorder? A pilot study.

    abstract:BACKGROUND AND PURPOSE:Physical therapists' teaching skills often are disregarded in research studies. We examined whether the use of different teaching principles during neuromotor task training was associated with treatment effects. SUBJECTS:Nineteen children (mean age=7 years 5 months, range=5-10 years) who had dev...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.2522/ptj.20050158

    authors: Niemeijer AS,Schoemaker MM,Smits-Engelsman BC

    更新日期:2006-09-01 00:00:00

  • Current principles in the nonoperative management of structural adolescent idiopathic scoliosis.

    abstract::Physical therapists routinely identify and manage adolescents with idiopathic scoliosis. Therefore, it is essential that we maintain a current understanding of both the condition and the treatment principles. This paper includes both a discussion of the personal impact on those left untreated and a review of current c...

    journal_title:Physical therapy

    pub_type: 杂志文章,评审

    doi:10.1093/ptj/63.4.512

    authors: Farady JA

    更新日期:1983-04-01 00:00:00

  • Planning infant learning programs.

    abstract::Based on a review of the literature, a theoretical basis for planning learning programs for infants is presented. The prerequisites for effective programming include attention to the characteristics of the learning environment, the infant or learner, and the stimulus-response mechanism. The goals of such a program inc...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/56.12.1347

    authors: Campbell SK,Wilson JM

    更新日期:1976-12-01 00:00:00

  • The meaning of occupation, occupational need, and occupational therapy in a military context.

    abstract::Despite occupational therapists having strong historical ties to the Canadian military, there are currently no uniformed occupational therapists and only a few permanent occupational therapists employed by Canadian Forces. Occupational therapy is provided, in the main, through civilian occupational therapists. Occupat...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.2522/ptj.20120162

    authors: Brown HV,Hollis V

    更新日期:2013-09-01 00:00:00

  • Test-Retest Reliability of Dual-Task Outcome Measures in People With Parkinson Disease.

    abstract:BACKGROUND:Dual-task (DT) training is gaining ground as a physical therapy intervention in people with Parkinson disease (PD). Future studies evaluating the effect of such interventions need reliable outcome measures. To date, the test-retest reliability of DT measures in patients with PD remains largely unknown. OBJE...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.2522/ptj.20150244

    authors: Strouwen C,Molenaar EA,Keus SH,Münks L,Bloem BR,Nieuwboer A

    更新日期:2016-08-01 00:00:00

  • Effect of station examination item sampling on generalizability of student performance.

    abstract::This article may be of interest to physical therapy educators who are responsible for structuring station or practical examinations used to evaluate physical therapy students. The global intent of the article is to provide information that may be useful in selecting test items. Specifically, the purposes of this study...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/70.1.31

    authors: Stratford PW,Thomson MA,Sanford J,Saarinen H,Dilworth P,Solomon P,Nixon P,Fraser-MacDougall V,Pierce-Fenn H

    更新日期:1990-01-01 00:00:00

  • Sleep enhances learning of a functional motor task in young adults.

    abstract:BACKGROUND:Sleep has been demonstrated to enhance simple motor skill learning "offline" in young adults. "Offline learning" refers to either the stabilization or the enhancement of a memory through the passage of time without additional practice. It remains unclear whether a functional motor task will benefit from slee...

    journal_title:Physical therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.2522/ptj.20120502

    authors: Al-Sharman A,Siengsukon CF

    更新日期:2013-12-01 00:00:00

  • Whirlpool versus whirlpool rinse for removal of bacteria from a venous stasis ulcer.

    abstract::The number of bacteria removed from a venous stasis ulcer by whirlpool treatment alone and that removed by whirlpool treatment followed by vigorous rinsing are compared. A single subject received the whirlpool treatment followed by the rinse on 12 separate occasions. The number of bacteria removed was determined by ta...

    journal_title:Physical therapy

    pub_type: 杂志文章

    doi:10.1093/ptj/62.3.304

    authors: Bohannon RW

    更新日期:1982-03-01 00:00:00