Classification of Lumbar Spine Impairments: Difference between revisions
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The best available evidence supports a classification approach that de-emphasizes the importance of identifying specific anatomical lesions after red flag screening is completed. | == Introduction == | ||
<blockquote>"The best available evidence supports a classification approach that de-emphasizes the importance of identifying specific anatomical lesions after red flag screening is completed."<ref name=":0">Delitto A, George SZ, Van Dillen L, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ; Orthopaedic Section of the American Physical Therapy Association. [https://www.jospt.org/doi/10.2519/jospt.2012.42.4.A1 Low back pain]. J Orthop Sports Phys Ther. 2012 Apr;42(4):A1-57. </ref></blockquote>Several classification systems have been published to help clinicians select an appropriate intervention for patients with low back pain, including: | |||
* Treatment-based Classification (TBC)<ref>Delitto A, Erhard RE, Bowling RW. A treatment-based classification approach to low back syndrome: identifying and staging patients for conservative treatment. Phys Ther. 1995 Jun;75(6):470-85; discussion 485-9.</ref><ref>Alrwaily M, Timko M, Schneider M, Stevans J, Bise C, Hariharan K, Delitto A. [https://academic.oup.com/ptj/article/96/7/1057/2864925 Treatment-based classification system for low back pain: revision and update.] Physical therapy. 2016 Jul 1;96(7):1057-66.Delitto A, Erhard RE, Bowling RW. A treatment-based classification approach to low back syndrome: identifying and staging patients for conservative treatment. Phys Ther. 1995 Jun;75(6):470-85; discussion 485-9.</ref> | |||
* Mechanical Diagnosis and Therapy (MDT) (also known as the McKenzie Method) | |||
* Movement System Impairment (MSI)<ref>Azevedo DC, Ferreira PH, Santos HD, Oliveira DR, de Souza JV, Costa LO. [https://academic.oup.com/ptj/article/98/1/28/4107780?login=false Movement system impairment-based classification treatment versus general exercises for chronic low back pain: randomized controlled trial.] Physical therapy. 2018 Jan;98(1):28-39.</ref> | |||
These classifications and others are discussed here: [[Treatment-based Classification System for Low Back Pain|Treatment-based Classification for Low Back Pain]]. | |||
This page supports the Plus course, Classification of Lumbar Spine Impairments, by Dr. Shala Cunningham. It discusses a classification system based on the TBC with several key differences:<ref name=":0" /> | |||
* the categories include specific International Classification of Functioning, Disability and Health (ICF) terminology related to impairments of body function | |||
* additional categories related to cognitive / affective disorders and generalised pain categories have been included | |||
* it considers the patient’s level of acuity | |||
The categories are: | |||
* low back pain with mobility deficits | |||
* low back pain with movement coordination impairments | |||
* low back pain with related lower extremity pain' | |||
* low back pain with radiating pain | |||
* low back pain with related cognitive or affective disorders | |||
* low back pain with related generalized pain | |||
To learn more about the ICF, please see: [[International Classification of Functioning, Disability and Health (ICF)]]. | |||
The following sections describe specific symptoms, impairments and possible interventions based on these categories. | |||
== References == | |||
[[Category:Plus Content]] | |||
[[Category:Course Pages]] | |||
[[Category:Lumbar Spine]] | |||
[[Category:Lumbar Spine - Assessment and Examination]] |
Revision as of 23:23, 18 February 2024
Introduction[edit | edit source]
"The best available evidence supports a classification approach that de-emphasizes the importance of identifying specific anatomical lesions after red flag screening is completed."[1]
Several classification systems have been published to help clinicians select an appropriate intervention for patients with low back pain, including:
- Treatment-based Classification (TBC)[2][3]
- Mechanical Diagnosis and Therapy (MDT) (also known as the McKenzie Method)
- Movement System Impairment (MSI)[4]
These classifications and others are discussed here: Treatment-based Classification for Low Back Pain.
This page supports the Plus course, Classification of Lumbar Spine Impairments, by Dr. Shala Cunningham. It discusses a classification system based on the TBC with several key differences:[1]
- the categories include specific International Classification of Functioning, Disability and Health (ICF) terminology related to impairments of body function
- additional categories related to cognitive / affective disorders and generalised pain categories have been included
- it considers the patient’s level of acuity
The categories are:
- low back pain with mobility deficits
- low back pain with movement coordination impairments
- low back pain with related lower extremity pain'
- low back pain with radiating pain
- low back pain with related cognitive or affective disorders
- low back pain with related generalized pain
To learn more about the ICF, please see: International Classification of Functioning, Disability and Health (ICF).
The following sections describe specific symptoms, impairments and possible interventions based on these categories.
References[edit | edit source]
- ↑ 1.0 1.1 Delitto A, George SZ, Van Dillen L, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ; Orthopaedic Section of the American Physical Therapy Association. Low back pain. J Orthop Sports Phys Ther. 2012 Apr;42(4):A1-57.
- ↑ Delitto A, Erhard RE, Bowling RW. A treatment-based classification approach to low back syndrome: identifying and staging patients for conservative treatment. Phys Ther. 1995 Jun;75(6):470-85; discussion 485-9.
- ↑ Alrwaily M, Timko M, Schneider M, Stevans J, Bise C, Hariharan K, Delitto A. Treatment-based classification system for low back pain: revision and update. Physical therapy. 2016 Jul 1;96(7):1057-66.Delitto A, Erhard RE, Bowling RW. A treatment-based classification approach to low back syndrome: identifying and staging patients for conservative treatment. Phys Ther. 1995 Jun;75(6):470-85; discussion 485-9.
- ↑ Azevedo DC, Ferreira PH, Santos HD, Oliveira DR, de Souza JV, Costa LO. Movement system impairment-based classification treatment versus general exercises for chronic low back pain: randomized controlled trial. Physical therapy. 2018 Jan;98(1):28-39.