Derivation and validation phase for the development of clinical prediction rules for rehabilitation in chronic nonspecific low back pain patients: study protocol for a randomized controlled trial

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• 作者：Lenie Denteneer (29)
  Gaetane Stassijns (29) (30)
  Willem De Hertogh (29)
  Steven Truijen (29)
  Nienke Jansen (31)
  Ulrike Van Daele (29)
  
  29. Faculty of Medicine and Health Sciences ; University of Antwerp ; Universiteitsplein 1 ; 2610 ; Wirlijk ; Belgium
  30. Department of Physical Medicine and Rehabilitation ; Antwerp University Hospital ; Universiteitsplein 1 ; 2610 ; Wirijk ; Belgium
  31. Faculty of Medicine and Pharmacy ; Free University of Brussels ; Laarbeeklaan 103 ; 1090 ; Jette ; Belgium
  
• 关键词：Clinical prediction rule ; Nonspecific ; Chronic ; Low back pain
• 刊名：Trials
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：16
• 期：1
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• 刊物主题：Medicine/Public Health, general; Biomedicine general; Statistics for Life Sciences, Medicine, Health Sciences;
• 出版者：BioMed Central
• ISSN：1745-6215

文摘

Background There is a consensus that exercise therapy should be used as a therapeutic approach in chronic low back pain (CLBP) but little consensus has been reached about the preferential type of therapy. Due to the heterogeneity of the population no clear effect of specific therapy interventions are found. Probably a specific subgroup of the investigated population will benefit from the intervention and another subgroup will not benefit, looking at the total investigated population no significant effects can be found. Therefore there is a need for the development of clinical prediction rules (CPRs). Objectives for this trial are first, the derivation of CPRs to predict treatment response to three forms of exercise therapy for patients with nonspecific CLBP. Secondly, we aim to validate a CPR for the three forms of exercise therapy for patients with nonspecific CLBP. Methods/Design The study design is a randomized controlled trial. Patients with nonspecific CLBP of more than three months duration are recruited at the Antwerp University Hospital (Belgium) and Apra Rehabilitation Hospital. After examination, patients are randomly assigned to one of three intervention groups: motor control therapy, general active exercise therapy and isometric training therapy. All patients will undergo 18 treatment sessions during nine weeks. Measurements will be taken at baseline, nine weeks, six months and at one year. The primary outcome used is the Modified Oswestry Disability Questionnaire score. For each type of exercise therapy a CPR will be derived and validated. For validation, the CPR will be applied to divide each treatment group into two subgroups (matched and unmatched therapy) using the baseline measurements. We predict a better therapeutic effect for matched therapy. Discussion A randomized controlled trial has not previously been performed for the development of a CPR for exercise therapy in CLBP patients. Only one CPR was described in a single-arm design for motor control therapy in sub-acute non-radicular LBP patients. In this study, a sufficiently large sample will be included in both the derivation and validation phase. Trial registration This trial was registered with Clinicaltrials.gov on 10 February 2014, registration number: NCT02063503.