Treatment monitoring as a component of psychologically informed physical therapy: A case series of patients at high risk for persistent low back pain related disability.
Jason M Beneciuk, Lindsay A Ballengee, Steven Z George
PMID 30909109WHAT IT FOUND
In high-risk low back pain patients, changes in psychological scores predicted disability outcomes better than physical impairment scores.
However, neither predicted pain intensity changes better than the patient's baseline pain score. Use psychological measures to track functional recovery, not pain.
Key findings
01Changes in psychological measures (FABQ, PCS, TSK-11, FDAQ) significantly improved the prediction of 4-week disability scores, whereas changes in the Physical Impairment Index did not.
02No treatment monitoring measure improved the prediction of 4-week pain intensity scores beyond what was explained by the patient's baseline pain score.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was very small (23 patients), which limits the precision of the statistical estimates and prevents definitive conclusions. The study only included high-risk patients, so the results cannot be applied to low or medium-risk patients. Measures were taken only at baseline and 4 weeks, missing potential trends or non-linear changes that might occur during the treatment episode. This is a case series without a control group, so it cannot determine if the treatment itself caused the outcomes, only how well the monitoring measures predicted them.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not interpret the lack of predictive value for pain intensity as evidence that psychological factors do not influence pain perception. The study only showed that changes in these specific monitoring scores did not predict pain scores better than the baseline pain score in this small sample.