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Review Article

An Overview of Clinical Prediction Rules in Low Back Pain: Clinical Decision Making in Likelihood for (UN) Certainty

Kumar Senthil P.* , Kumar Senthil P.* , Kumar Anup**

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Journal of Orthopedic Education 3(1):p 107-110, January - June 2017. | DOI: DOI: http://dx.doi.org/10.21088/joe.2454.7956.3117.20

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Abstract

Clinical prediction rules (CPR) or clinical decision rules (CDR) use a cluster of symptoms and signs to identify and subgroup patients who were likely to present with a particular diagnosis (diagnostic CPR), or to respond to a treatment (therapeutic CPR) or to have a change in outcome (prognostic CPR). The objective of this review article was to update the utility of CPRs for clinical decision making in evaluation and treatment of people with low back pain (LBP) from an evidence­informed perspective. The CPRs on LBP provide a clinical direction but not a defnitive decision rule for predicting diagnosis, therapy and prognosis. There were two reviews, four studies on spinal manipulation, one study on stabilization exercise, one study on mechanical diagnosis and therapy, one study on pilates­based exercise and one study on mechanical lumbar traction. In addition, there was one study each on prescription, rate of recovery and return to work. The reviewed studies were mostly on development and few were on validation, with no study found on impact analysis of CPR in LBP. There is thus scope for future research in this area.

Keywords: Clinical Examination; Clinical Decision Making; Orthopedic Decision Making; Orthopedic Rehabilitation.

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DOI: DOI: http://dx.doi.org/10.21088/joe.2454.7956.3117.20

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