How can you, as a patient, be confident that you will be treated with a standard of care based on sound clinical research?

Part of the answer lies within the "clinical prediction rules" which was a concept introduced in an earlier article.

A clinical prediction rule is a type of practice in which researchers try to identify the best combination of medical signs, symptoms, and other findings to predict the probability of a specific disease or treatment outcome.

In the field of physical therapy, clinical prediction rules are currently being developed for a variety of musculoskeletal problems. The goal is to treat each individual problem with the proper and specific treatment strategy. One of the most common problems we see in physical therapy is low back pain. Fortunately, much of the work surrounding clinical prediction rules has been performed in the area of low back pain.

What does that mean for you as a low back pain patient? Most importantly, it means your back pain needs to be treated with a specific treatment approach. In other words, some back pain responds to traction, some back pain responds to manual therapy, while some back pain responds best to stabilization exercises. Back pain is not a homogeneous grouping. There are sub groups within the larger group of "back pain". This is where clinical prediction rules come in.  A skilled, knowledgeable, and up-to-date physical therapist will be able to identify your combination of signs and symptoms and classify your back pain according to appropriate clinical prediction rules.

Currently, clinical prediction rules exist to identify low back pain patients who are appropriate for manipulation, stabilization, motion preference, and traction.

Now for the best part. Treatment which follows clinical prediction rules actually works, and there is clinical evidence to support their use. For example, one study involving low back patients who were classified into the stabilization category, found that when two predicting factors were present, 94% of the patients experienced improvement in their symptoms.

Quite honestly, there is a lot that goes on in physical therapy that is not supported by evidence.  That is why our mantra is "not all therapy is the same." If you have a back problem, you need to be treated by a therapist who is familiar with the use of clinical prediction rules to appropriately classify your low back problem.

In upcoming issues, we will explore how the therapists at First Choice Rehab have employed clinical prediction rules for the low back as well as present our low back patient outcomes.