The impact of contextual effects in exercise therapy for low back pain: a systematic review and meta-analysis.

Background: Low back pain is the leading cause of global disability for which exercise therapy is a widely recommended treatment. Research indicates that contextual factors may also influence treatment outcomes in low back pain. Examples include the patient-therapist relationship and other treatment-related circumstances that affect patient expectations.

Tailoring and Evaluating Treatment with the Patient-Specific Needs Evaluation: A Patient-Centered Approach.

Background: No patient-reported instrument assesses patient-specific information needs, treatment goals, and personal meaningful gain (PMG), a novel construct evaluating individualized, clinically relevant improvement. This study reports the development of the Patient-Specific Needs Evaluation (PSN) and examines its discriminative validity (ie, its ability to distinguish satisfied from dissatisfied patients) and test-retest reliability in patients with hand or wrist conditions.

Methods: A mixed-methods approach was used to develop and validate the PSN, following Consensus-Based Standards for the Selection of Health Measurement Instruments guidelines, including pilot testing, a survey (pilot, n = 223; final PSN, n = 275), cognitive debriefing ( n = 16), expert input, and validation.