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 .
Prediction of the Clinical Course of Low-Back Trouble Using Multivariable Models
The inability to predict outcome in patients with low-back pain seriously impedes clinical trials and leads to inappropriate or unnecessary treatment . This prospect i ve study investigated the value of multivariable mathematical models to predict the 1-year clinical course of 109 patients with low-back trouble ( LBT ) . Discriminant analysis was used to determine predictive models for outcome groups at 1 month , 3 months and 1 year . The variables selected in the analyses were subsets of 29 items from a clinical interview at presentation . These included anamnestic features of the first episode as well as symptomatic details and results from clinical tests for the current spell . The derived models successfully discriminated outcome groups with estimates of sensitivity and specificity ranging from 63 to 99 % . When models from one set of patients were tested for predictive accuracy by the application of them to a different set , nonrecovery and satisfactory improvement were predicted with a 76–100 % success rate . The results affirmed the importance of considering combinations of interrelated variables for prediction and discrimination in LBT . This work has demonstrated that outcome can be predicted successfully by the use of mathematic models based just on presentation data . The ability to determine homogenous groups in respect to outcome is seen as an important aid to therapeutic research ; further work will enable refinement of these models for general clinical use and for incorporation into computer-based interview systems
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 .