Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study

The objective is to determine if pain and disability outcomes of patients treated with neural mobilisation differ for sub-classifications of low back and leg pain (LB&LP). Radiating leg pain is a poor prognostic factor for recovery in patients with LBP. To improve outcome, a new pathomechanism-b...

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Main Authors: Schäfer, Axel, Hall, Toby, Müller, G., Briffa, Kathy
Format: Journal Article
Published: Springer 2011
Online Access:http://hdl.handle.net/20.500.11937/49158
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author Schäfer, Axel
Hall, Toby
Müller, G.
Briffa, Kathy
author_facet Schäfer, Axel
Hall, Toby
Müller, G.
Briffa, Kathy
author_sort Schäfer, Axel
building Curtin Institutional Repository
collection Online Access
description The objective is to determine if pain and disability outcomes of patients treated with neural mobilisation differ for sub-classifications of low back and leg pain (LB&LP). Radiating leg pain is a poor prognostic factor for recovery in patients with LBP. To improve outcome, a new pathomechanism-based classification system was proposed: neuropathic sensitization (NS), denervation (D), peripheral nerve sensitization (PNS) and musculoskeletal (M). Seventy-seven patients with unilateral LB&LP were recruited. Following classification, all subjects were treated seven times with neural mobilisation techniques. A successful outcome was defined as achieving a minimal clinically important change in pain intensity (11-point numerical rating scale), physical function (Roland Morris disability questionnaire) and global perceived change (7-point Likert scale: from 1 = “completely recovered” to 7 = “worse than ever”). The proportion of responders was significantly greater in PNS (55.6%) than the other three groups (NS 10%; D 14.3% and M10%). After adjusting for baseline differences, mean magnitude of improvement of the outcome measures were significantly greater in PNS compared to the other groups. Patients classified as PNS have a more favourable prognosis following neural mobilisation compared to the other groups.
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spelling curtin-20.500.11937-491582018-03-29T09:07:45Z Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study Schäfer, Axel Hall, Toby Müller, G. Briffa, Kathy The objective is to determine if pain and disability outcomes of patients treated with neural mobilisation differ for sub-classifications of low back and leg pain (LB&LP). Radiating leg pain is a poor prognostic factor for recovery in patients with LBP. To improve outcome, a new pathomechanism-based classification system was proposed: neuropathic sensitization (NS), denervation (D), peripheral nerve sensitization (PNS) and musculoskeletal (M). Seventy-seven patients with unilateral LB&LP were recruited. Following classification, all subjects were treated seven times with neural mobilisation techniques. A successful outcome was defined as achieving a minimal clinically important change in pain intensity (11-point numerical rating scale), physical function (Roland Morris disability questionnaire) and global perceived change (7-point Likert scale: from 1 = “completely recovered” to 7 = “worse than ever”). The proportion of responders was significantly greater in PNS (55.6%) than the other three groups (NS 10%; D 14.3% and M10%). After adjusting for baseline differences, mean magnitude of improvement of the outcome measures were significantly greater in PNS compared to the other groups. Patients classified as PNS have a more favourable prognosis following neural mobilisation compared to the other groups. 2011 Journal Article http://hdl.handle.net/20.500.11937/49158 10.1007/s00586-010-1632-2 Springer restricted
spellingShingle Schäfer, Axel
Hall, Toby
Müller, G.
Briffa, Kathy
Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study
title Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study
title_full Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study
title_fullStr Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study
title_full_unstemmed Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study
title_short Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study
title_sort outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study
url http://hdl.handle.net/20.500.11937/49158