Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program

Hicks, Gregory E.; Fritz, Julie M.; Delitto, Anthony; McGill, Stuart M.

doi:10.1016/j.apmr.2005.03.033

Cited by 621Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyMedical Practices and Rehabilitation

Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program

Hicks, Gregory E., Fritz, Julie M., Delitto, Anthony, McGill, Stuart M.·2005·Archives of Physical Medicine and Rehabilitation

DOI 10.1016/j.apmr.2005.03.033

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Abstract

Objective To develop a clinical prediction rule to predict treatment response to a stabilization exercise program for patients with low back pain (LBP).Design A prospective, cohort study of patients with nonradicular LBP referred to physical therapy (PT).Setting Outpatient PT clinics.Participants Fifty-four patients with nonradicular LBP.Intervention A standardized stabilization exercise program.Main outcome measure Treatment response (success or failure) was categorized based on changes in the Oswestry Disability Questionnaire scores after 8 weeks.Results Eighteen subjects were categorized as treatment successes, 15 as treatment failures, and 21 as somewhat improved. After using regression analyses to determine the association between standardized examination variables and treatment response status, preliminary clinical prediction rules were developed for predicting success (positive likelihood ratio [LR], 4.0) and failure (negative LR, .18). The most important variables were age, straight-leg raise, prone instability test, aberrant motions, lumbar hypermobility, and fear-avoidance beliefs.Conclusions It appears that the response to a stabilization exercise program in patients with LBP can be predicted from variables collected from the clinical examination. The prediction rules could be used to determine whether patients with LBP are likely to benefit from stabilization exercises.

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Determining the optimal dose for maximal treatment success is still a matter of debate.
“Likewise, determining the optimal dose for maximal treatment success (response) is still a matter of debate [12,13].”
From Sustainability effects of motor control stabilisation exercises on pain and function in chronic nonspecific low back pain patients: A systematic review with meta-analysis and meta-regression (2020) · cites this paper as [12]
The optimal dose-response relationship for the utmost treatment success is still unknown.
“The optimal dose-response-relationship for the utmost treatment success is, thus, still unknown.”
From Dose-response-relationship of stabilisation exercises in patients with chronic non-specific low back pain: a systematic review with meta-regression (2020) · cites this paper as [10]

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Authors: Hicks, G. E., Fritz, J. M., Delitto, A., & McGill, S. M.
Affiliations: University of Maryland, Baltimore (US)
University of Utah (US)
University of Pittsburgh (US)
University of Waterloo (CA)
Corresponding author: Hicks, Gregory E.
ORCID: Hicks, Gregory E.
Fritz, Julie M.
Delitto, Anthony
McGill, Stuart M.
Venue: Archives of Physical Medicine and Rehabilitation
Publisher: Elsevier BV
Published: 2005-09
Volume: 86
Issue: 9
Pages: 1753-1762
ISSN: 0003-9993 (ISSN-L)
DOI: 10.1016/j.apmr.2005.03.033
OpenAlex: W2124409697
Cited by: 621
References: 77
Citations by year: 2026: 5 · 2025: 17 · 2024: 16 · 2023: 22 · 2022: 21 · 2021: 21 · 2020: 21 · 2019: 21 · 2018: 36 · 2017: 24 · 2016: 34 · 2015: 45 · 2014: 30 · 2013: 38 · 2012: 50
FWCI: 22.54
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Archives of Physical Medicine and Rehabilitation (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords: low back pain, stabilization exercises, clinical prediction rules, treatment response prediction, physiotherapy, Oswestry Disability Index, straight leg raise, fear-avoidance beliefs, age
MeSH terms: Adult, Exercise Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pain Measurement, Predictive Value of Tests, Probability, Prospective Studies, Risk Factors, Severity of Illness Index, Cohort Studies, Confidence Intervals, Treatment Outcome, Low Back Pain, Physical Therapy Modalities

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Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program

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