Most of the outcome question naires had a mixed content reflecting various constructs such as pain and symptoms , sleep disturbances , psychological dysfunctions , physical impairments , and social functions .
STUDY DESIGN A systematic literature review of outcome question naires design ed for assessing functional status or disability in patients with low back pain .
OBJECTIVES To provide a comprehensive overview of all functioning/disability question naires used in recent years and to explore how the main concept(s ) was described or defined in the original paper , the content or the domains of disability , and the measurement properties of the question naires .
SUMMARY OF BACKGROUND DATA A number of clinical tools design ed for evaluating the functional status of patients with low back pain have been developed .
Only a few have been review ed earlier , and there has been little focus on the content reflected in the question naires .
Coordination of Primary Health Care for Back Pain: A Randomized Controlled Trial
Study Design . A r and omized controlled trial comparing usual care with a program for the coordination of primary health care ( CORE ) for the treatment of subacute low-back pain patients . Objectives . To measure the effectiveness of the CORE program  as a mean for implementing clinical practice guidelines for low-back pain in an urban community . Summary of Background Data . Clinical practice guidelines have been developed for primary care physicians and patients on the clinical management of low-back pain . The implementation of the guidelines in a large community is difficult with the multiplicity of medical and nonmedical back care providers and products . The CORE program was design ed to make the guidelines fit in this complex environment . Methods . One hundred ten workers compensated for low-back pain for 4 to 8 weeks in metropolitan Montreal were r and omized in two groups : usual care ( N=56 ) and the CORE program ( N=54 ) . Coordination of primary health care was performed by two primary care physicians and a nurse in liaison with the treating physicians , and included a complete examination , recommendations for the clinical management , and support to carry out the recommendations . All workers were followed for 6 months . Back pain and functional status were assessed at baseline , 3 months , and 6 months . Results . In the 6-month follow-up , the CORE group returned to work 6.6 days ( st and ard error = 8.9 ) quicker than the control group , a difference that was not statistically significant . However , the CORE group showed a sustained improvement in pain and functional status with two-fold differences at the end of the 6 months of follow-up . This represented nine points on the Oswestry scale ( P = 0.02 ) and 12 points on the Quebec Back Pain Disability Scale ( P = 0.01 ) . The CORE group also used three times less specialized imaging tests of the spine at 3 months ( P < 0.01 ) and exercised twice as much at 6 months ( P < 0.05 ) than the controls . Conclusions . The therapeutic results for workers with low-back pain could be improved by implementing the clinical practice guidelines with primary care physicians in a large community , without delaying the return to work . The CORE intervention for back pain patients ishighly relevant to primary care practice . It is simple in its application , flexible to accommo date physicians ’ and patients ’ preferences in health care , and it is effective on patients ’ clinical outcome
Most of the outcome question naires had a mixed content reflecting various constructs such as pain and symptoms , sleep disturbances , psychological dysfunctions , physical impairments , and social functions .
STUDY DESIGN A systematic literature review of outcome question naires design ed for assessing functional status or disability in patients with low back pain .
OBJECTIVES To provide a comprehensive overview of all functioning/disability question naires used in recent years and to explore how the main concept(s ) was described or defined in the original paper , the content or the domains of disability , and the measurement properties of the question naires .
SUMMARY OF BACKGROUND DATA A number of clinical tools design ed for evaluating the functional status of patients with low back pain have been developed .
Only a few have been review ed earlier , and there has been little focus on the content reflected in the question naires .