The prognostic value of symptom responses in the conservative management of spinal pain : a systematic review
Chorti, Angeliki G., Chortis, Anastasios G., Strimpakos, Nikolaos, McCarthy, C. J. and Lamb, S. E. (Sallie E.) (2009) The prognostic value of symptom responses in the conservative management of spinal pain : a systematic review. Spine, Vol.34 (No.24). pp. 2686-2699. ISSN 0362-2436Full text not available from this repository.
Official URL: http://dx.doi.org/10.1097/BRS.0b013e3181b43a41
Study Design. Systematic review.
Objective. To investigate the prognostic value of clinically induced changes in spinal symptoms (i.e., symptom response) in the conservative management of spinal pain.
Summary of Background Data. Symptom response is used by clinicians to inform management decisions. Understanding the prognostic value of symptom response can aid in this decision-making process. Methods. A search of Ovid-Medline, Ovid-Embase, Ovid-Cinahl, Ovid-Amed, reference lists and citation tracking was performed. Methodologic quality was assessed independently by 2 raters.
Results. We included 22 articles reporting 18 different cohorts. The evidence was limited and mainly involved low back pain. We found no association between most symptom responses and clinical outcomes. Only for changes in pain location and/or intensity with repeated spinal movement testing or as a response to treatment did the data provide support for use of symptom response to inform management. Further work is needed to confirm these findings. Limited evidence of an association with disability was found for the prone instability test in low back pain patients attending a stabilization program. The evidence for neurodynamic testing was conflicting for low back pain. The strength of identified associations and the extent of confounding between investigated prognostic factors remain uncertain.
Conclusion. Further investigation of symptom responses in spinal pain is needed before their use can be recommended.
|Item Type:||Journal Item|
|Subjects:||R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RC Internal medicine
|Divisions:||Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
|Library of Congress Subject Headings (LCSH):||Spine -- Wounds and injuries -- Treatment, Pain -- Treatment -- Research, Systematic reviews (Medical research)|
|Journal or Publication Title:||Spine|
|Publisher:||Lippincott Williams & Wilkins|
|Official Date:||15 November 2009|
|Number of Pages:||14|
|Page Range:||pp. 2686-2699|
|Access rights to Published version:||Restricted or Subscription Access|
|Funder:||Hellenic State Scholarships Foundation (HSSF)|
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