Clinical examination findings as prognostic factors in low back pain: a systematic review of the literature

doi:10.1186/s12998-015-0054-y

PMC full text:

Chiropr Man Therap. 2015; 23: 13.

Published online 2015 Mar 23. doi: 10.1186/s12998-015-0054-y

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Table 3

Associations between prognostic factors and outcome

Prognostic indicator at baseline	Association with poor outcome	Pain	Disability	Return to work	UHC ¹	GI ²	Combination
Centralization	Positive	[25] ^a[55]^a [67]^a	[25] ^a[38]^a[67]^a

short-term	None	[67]	[55][37]

Centralization	Positive	[25] ^a	[25] ^a[67]^a	[55]^a	[67]^a

long-term	None	[67][32−/−]	[67][55][32−/−]	[67][55][32−/−]	[67]

Peripheralization	Positive	[25] ^a	[25] ^a

short-term	None		[38]

Peripheralization	Positive	[25] ^a	[25] ^a

long-term	None	[32−/−]	[32−/−]	[32−/−]

Palpation tone, pain, symmetry	Positive

Prognostic indicator at baseline	Association with poor outcome	Pain	Disability	Return to work	UHC ¹	GI ²	Combination
short-term	none	[54]	[37][54]			[72][68]	[45−/−]

Palpation tone, pain, symmetry	Positive		[48] ^b

long-term	none	[54]	[54]	[64]	[69]

Palpation mobility	Positive		[46+/+] ^a [37+/+] ^a

short-term	none	[36?/-]	[39][38][36?/-]			[36?/-]

ROM³ spine	Positive						[29] ^a

short-term	None	[47?/-]	[37][46][38]	[33] [47?/-]		[68][47?/-]	[29][33]

ROM³ spine	Positive	[35][28]	[48] ^b	[50+/+][62+/?] ^a			[29]

Prognostic indicator at baseline	Association with poor outcome	Pain	Disability	Return to work	UHC ¹	GI ²	Combination
long-term	None	[63?/-]	[35][30] ^b[66]	[28][31][50] [62][66][64]	[69+/−]		[65][29]

FFD⁴	Positive					[72−/+] ^a	[45+/−]

short-term	None	[47?/-]	[44−/−]	[47?/-]		[47?/+][68][72]

FFD⁴	Positive			[49+/−]

long-term	None	[35]	[35][43−/−]

Schober’s test	Positive	[70+/−] ^b

long-term	None	[28]		[28]	[69]

Aberrant spinal movement	Positive	[46+/+] ^a	[33+/−]

Prognostic indicator at baseline	Association with poor outcome	Pain	Disability	Return to work	UHC ¹	GI ²	Combination
short-term	None						[33]

ROM³ of the hip	Positive		[37 − +/+]

short-term	None					[68]	[29]

ROM³ of the hip	Positive			[62]^b			[29]

long-term	None	[63−/−]		[31]			[29]

SI⁵ motion symmetry tests	Positive

short-term	None		[37]

Pain on spinal movement	Positive					[68]^a

Prognostic indicator at baseline	Association with poor outcome	Pain	Disability	Return to work	UHC ¹	GI ²	Combination
short-term	None	[54]	[54]			[68]

Pain on spinal movement	Positive

long-term	None	[54][56]	[54][56]		[56]

SI⁵ provocation tests	Positive		[40+/+]

short-term	None		[37][46][40]

SI⁵ provocation tests	Positive

long-term	None	[63?/-]

Prone instability test	Positive		[46+/+] ^a

short-term	None

Prognostic indicator at baseline	Association with poor outcome	Pain	Disability	Return to work	UHC ¹	GI ²	Combination
Percussion	Positive

short-term	None						[65]

Percussion	Positive

long-term	None						[65]

Muscle endurance	Positive

short-term	None	[59]	[46]

Muscle endurance	Positive	[35][27]		[27]

long-term	None	[35][59][27]	[35][27][57]	[27][31]		[27]

Prognostic indicator at baseline	Association with poor outcome	Pain	Disability	Return to work	UHC ¹	GI ²	Combination
Muscle strength	Positive

short-term	None		[46]

Muscle strength	Positive	[28]	[48] ^b	[28]

long-term	None			[31]

Neurological signs	Positive	[44]	[44+/+]	[63]		[72−/+][68]	[29]

short-term	None	[65][51][42]		[63]		[72]	[29]

Neurological signs	Positive	[43+/−][63?/+]	[43+/−][30] ^b	[58+/−]			[29]

long-term	None	[28][63?/-]	[43−/−]	[58][28][60][50][64]	[69]		[65][29]

SLR⁶	Positive		[46−/+][63]	[65+/−][63]		[72+/+][68]	[29]

short-term	None	[51]		[33]		[72][26]	[45−/−][29][33]

Prognostic indicator at baseline	Association with poor outcome	Pain	Disability	Return to work	UHC ¹	GI ²	Combination
SLR⁶	Positive		[30] ^b[61]		[69+/−]		[29]

long-term	None	[28][35][56][70−/−][63?/-]	[56][66][35]	[58][28][60][66][64]	[56]	[26]	[65]

Cross SLR⁶	Positive	[34]

short-term	None		[38]

Cross SLR⁶	Positive

long-term	None	[63?/-]

Femoral stretch	Positive					[72+/+][68]

short-term	None					[72]

Femoral stretch	Positive

long-term	None			[58]

Prognostic indicator at baseline	Association with poor outcome	Pain	Disability	Return to work	UHC ¹	GI ²	Combination
Naffziger sign	Positive

short-term	None					[72]

Non-organic signs	Positive			[73]			[29]

short-term	None		[37]				[29]

Non-organic signs	Positive			[52+/+][41+/?]	[41+/?]

long-term	None		[30] ^b	[53+/−][58+/−][71]	[41+/?]		[29]

Functional tests	Positive

short-term	None					[68]

Functional tests	Positive						[29][61]

long-term	None	[27]	[30] ^b[27]	[31][27][62]		[27]	[29]

Prognostic indicator at baseline	Association with poor outcome	Pain	Disability	Return to work	UHC ¹	GI ²	Combination
Leg length discrepancy	Positive						[29]

short-term	None						[29]

Leg length discrepancy	Positive

long-term	None			[64]

Bold indicates multivariable analysis, +/+ = result of univariate analysis/result of multivariable analysis,
^apredictor of recovery,
^bdirection of association unsure,
¹UHC = use of health care services or medication,
²GI = general. improvement,
³ROM = range of motion,
⁴FFD = fingertip to floor distance,
⁵SI = sacroiliac,
⁶SLR = straight leg raise.