Article

OBJECTIVE: To determine whether outcomes from treatment determined by subjects'
directional preference (ie, reduction in back and/or leg pain, by performing a
single direction of repeated end-range lumbar movement) would vary based on pain
duration, location, or neurologic status. DESIGN: A secondary analysis of data
from a multicenter randomized clinical trial. SETTING: Eleven physical therapy
departments or clinics in 5 countries, with referrals for both acute and chronic
low back pain. SUBJECTS: Seventy-one of 80 subjects with acute to chronic low
back pain, and with and without radicular leg pain, and with or without mild
neurologic deficit, were found at baseline to have a directional preference and
were then treated with directional exercises that matched their directional
preference. METHODS: All of the subjects were treated for 2 weeks with
directional exercises and compatible posture modifications. Independent variables
were pain duration, pain location, and neurologic status. MAIN OUTCOME
MEASUREMENTS: Primary measures were back and leg pain intensity and function
(Roland Morris Disability Questionnare). Secondary measures were activity
interference, medication use, depression (Beck Depression Inventory), and a
self-report of improvement. RESULTS: The subjects significantly improved their
back and leg pain intensity, disability, and all secondary outcome measures, but
pain duration, location, and neurologic status classification did not predict
treatment responsiveness. Across all pain duration categories, 91%-100% either
improved or resolved completely. There also was significant improvement across
all pain location and neurologic status categories, with no significant
differences across the outcome variables. CONCLUSIONS: In subjects found to have
a directional preference who then treated themselves with matching directional
exercises, neither pain duration nor pain location and neurologic status
predicted their uniformly good-to-excellent outcomes.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS