Conclusions For most clinical tests in LBP there is not consistent evidence for an association with outcome .
Central ization and non-organic signs are exceptions from that .
Background There is a strong tradition of performing a clinical examination of low back pain ( LBP ) patients and this is generally recommended in guidelines .
However , establishing a pathoanatomic diagnosis does not seem possible in most LBP patients and clinical tests may potentially be more relevant as prognostic factors .
The aim of this review of the literature was to systematic ally assess the association between low-tech clinical tests commonly used in adult patients with acute , recurrent or chronic LBP and short- and long-term outcome .
Is There a Subgroup of Patients With Low Back Pain Likely to Benefit From Mechanical Traction?: Results of a Randomized Clinical Trial and Subgrouping Analysis
Study Design . R and omized Clinical Trial . Objective . To identify a subgroup of patients with low back pain who are likely to respond favorably to an intervention including mechanical traction . Summary of Background Data . Previous research has failed to find evidence supporting traction for patients with low back pain . Previous studies have used heterogeneous sample s , although clinical experts tend to recommend traction for a more limited subgroup of patients with low back pain . Methods . Sixty-four subjects ( mean age 41.1 year , 56.3 % female ) with low back and leg pain and signs of nerve root compression were r and omized to receive a 6-week extension-oriented intervention with or without mechanical traction during the first 2 weeks . Between-group comparisons were conducted for changes in pain , disability , and fear-avoidance beliefs . Baseline variables were explored for potential as subgrouping criteria defining a subgroup of subjects likely to benefit from traction . Results . The group receiving traction showed greater improvements in disability ( adjusted mean difference in Oswestry change 7.2 points ) and fear-avoidance beliefs ( adjusted mean difference in FABQPA change 2.6 points ) after 2 weeks . There were no between-group differences after 6 weeks . Two baseline variables were associated with greater improvements with traction treatment ; peripheralization with extension movements and a crossed straight leg raise . Conclusion . A subgroup of patients likely to benefit from mechanical traction may exist . The results of this study suggest this subgroup is characterized by the presence of leg symptoms , signs of nerve root compression , and either peripheralization with extension movements or a crossed straight leg raise . Further research is needed to vali date this finding
Conclusions For most clinical tests in LBP there is not consistent evidence for an association with outcome .
Central ization and non-organic signs are exceptions from that .
Background There is a strong tradition of performing a clinical examination of low back pain ( LBP ) patients and this is generally recommended in guidelines .
However , establishing a pathoanatomic diagnosis does not seem possible in most LBP patients and clinical tests may potentially be more relevant as prognostic factors .
The aim of this review of the literature was to systematic ally assess the association between low-tech clinical tests commonly used in adult patients with acute , recurrent or chronic LBP and short- and long-term outcome .