Self-efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain.

Pain self-efficacy and fear of movement have been proposed to explain how pain can lead to disability for patients with chronic low back pain. However the extent to which pain self-efficacy and fear of movement mediate the relationship between pain and disability over time has not been investigated. This study aimed to investigate whether pain self-efficacy and/or fear of movement mediate the relationship between pain intensity and disability in patients with recent onset chronic low back pain.

PACE--the first placebo controlled trial of paracetamol for acute low back pain: design of a randomised controlled trial.

Background: Clinical practice guidelines recommend that the initial treatment of acute low back pain (LBP) should consist of advice to stay active and regular simple analgesics such as paracetamol 4 g daily. Despite this recommendation in all international LBP guidelines there are no placebo controlled trials assessing the efficacy of paracetamol for LBP at any dose or dose regimen. This study aims to determine whether 4 g of paracetamol daily (in divided doses) results in a more rapid recovery from acute LBP than placebo.

The influence of the therapist-patient relationship on treatment outcome in physical rehabilitation: a systematic review.

Background: The working alliance, or collaborative bond, between client and psychotherapist has been found to be related to outcome in psychotherapy.

Purpose: The purpose of this study was to investigate whether the working alliance is related to outcome in physical rehabilitation settings.

Data Sources: A sensitive search of 6 databases identified a total of 1,600 titles.

How is recovery from low back pain measured? A systematic review of the literature.

Recovery is commonly used as an outcome measure in low back pain (LBP) research. There is, however, no accepted definition of what recovery involves or guidance as to how it should be measured. The objective of the study was designed to appraise the LBP literature from the last 10 years to review the methods used to measure recovery.

Conservative interventions provide short-term relief for non-specific neck pain: a systematic review.

Question: Which interventions for non-specific neck pain are effective in reducing pain or disability?

Design: Systematic review with meta-analysis of randomised controlled trials.

Participants: Adults with non-specific neck pain.

Intervention: All interventions for neck pain that were evaluated in trials with a placebo, minimal- or no-intervention control.

Critical appraisal of clinical prediction rules that aim to optimize treatment selection for musculoskeletal conditions.

Background: Clinical prediction rules (CPRs) for treatment selection in musculoskeletal conditions have become increasingly popular.

Purpose: The purposes of this review are: (1) to critically appraise studies evaluating CPRs and (2) to consider the clinical utility and stage of development of each CPR.

Data Sources: Pertinent databases were searched up to April 2009.

Graded activity and graded exposure for persistent nonspecific low back pain: a systematic review.

Background: Graded activity and graded exposure are increasingly being used in the management of persistent low back pain; however, their effectiveness remains poorly understood.

Purpose: The aim of this study was to systematically review randomized controlled trials that evaluated the effectiveness of graded activity or graded exposure for persistent (>6 weeks in duration or recurrent) low back pain.

Data Sources: Trials were electronically searched and rated for quality by use of the PEDro scale (values of 0-10).

How little pain and disability do patients with low back pain have to experience to feel that they have recovered?

Epidemiological and clinical studies of people with low back pain (LBP) commonly measure the incidence of recovery. The pain numerical rating scale (NRS), scores from 0 to 10, and Roland Morris disability questionnaire (RMDQ), scores from 0 to 24, are two instruments often used to define recovery. On both scales higher scores indicate greater severity.

Treatment-based subgroups of low back pain: a guide to appraisal of research studies and a summary of current evidence.

There has been a recent increase in research evaluating treatment-based subgroups of non-specific low back pain. The aim of these sub-classification schemes is to identify subgroups of patients who will respond preferentially to one treatment as opposed to another. Our article provides accessible guidance on to how to interpret this research and determine its implications for clinical practice.

There was evidence of convergent and construct validity of Physiotherapy Evidence Database quality scale for physiotherapy trials.

Objective: To evaluate the convergent and construct validity of the Physiotherapy Evidence Database (PEDro) scale used to rate the methodological quality of randomized trials in physiotherapy.

Study Design And Setting: PEDro total scores and individual-item scores were extracted from 9,456 physiotherapy trials indexed on PEDro. Convergent validity was tested by comparing PEDro total scores with three other quality scales.

Low back pain and best practice care: A survey of general practice physicians.

Background: Acute low back pain (LBP) is primarily managed in general practice. We aimed to describe the usual care provided by general practitioners (GPs) and to compare this with recommendations of best practice in international evidence-based guidelines for the management of acute LBP.

Methods: Care provided in 3533 patient visits to GPs for a new episode of LBP was mapped to key recommendations in treatment guidelines.

Global Perceived Effect scales provided reliable assessments of health transition in people with musculoskeletal disorders, but ratings are strongly influenced by current status.

Objective: The study investigated the test-retest reliability and construct validity of the Global Perceived Effect (GPE) scale in patients with musculoskeletal disorders.

Study Design And Setting: Data from seven clinical studies including 861 subjects were used for the analyses. Repeat measures taken at the same attendance and from attendances separated by 24 hours were compared to estimate test-retest reliability.

Global rating of change scales: a review of strengths and weaknesses and considerations for design.

Most clinicians ask their patients to rate whether their health condition has improved or deteriorated over time and then use this information to guide management decisions. Many studies also use patient-rated change as an outcome measure to determine the efficacy of a particular treatment. Global rating of change (GRC) scales provide a method of obtaining this information in a manner that is quick, flexible, and efficient.

Can predictors of response to NSAIDs be identified in patients with acute low back pain?

Objectives: The aim of this study was to determine whether certain patient characteristics could identify people with acute low back pain who were more likely to respond to nonsteroidal anti-inflammatory drugs (NSAIDs), when administered in combination with paracetamol.

Methods: This study involved a secondary analysis of a randomized controlled trial investigating the efficacy of diclofenac in 239 patients presenting to general practitioners for acute low back pain. All patients received advice to "stay active" and take regular paracetamol and then were randomized to receive either diclofenac (50 mg twice daily) or placebo.

Execution and outcome differences between passes to the left and right made by first-grade rugby union players.

Objectives: To examine bilateral ball-passing skills whilst running amongst first-grade rugby union footballers.

Design: Within-group design

Setting: NSW Rugby Training facilities, Moore Park, Sydney.

Participants: One international player used as a case study and twenty, first grade rugby union players.

Motor control exercise for chronic low back pain: a randomized placebo-controlled trial.

Background: The evidence that exercise intervention is effective for treatment of chronic low back pain comes from trials that are not placebo-controlled.

Objective: The purpose of this study was to investigate the efficacy of motor control exercise for people with chronic low back pain.

Design: This was a randomized, placebo-controlled trial.

Prognosis for patients with chronic low back pain: inception cohort study.

Objectives: To describe the course of chronic low back pain in an inception cohort and to identify prognostic markers at the onset of chronicity.

Design: Inception cohort study with one year follow-up.

Setting: Primary care clinics in Sydney, Australia.

Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain.

Objective: To determine the prevalence of serious pathology in patients presenting to primary care settings with acute low back pain, and to evaluate the diagnostic accuracy of recommended "red flag" screening questions.

Methods: An inception cohort of 1,172 consecutive patients receiving primary care for acute low back pain was recruited from primary care clinics in Sydney, Australia. At the initial consultation, clinicians recorded responses to 25 red flag questions and then provided an initial diagnosis.

Indexing of randomised controlled trials of physiotherapy interventions: a comparison of AMED, CENTRAL, CINAHL, EMBASE, hooked on evidence, PEDro, PsycINFO and PubMed.

Objective: To compare the comprehensiveness of indexing the reports of randomised controlled trials of physiotherapy interventions by eight bibliographic databases (AMED, CENTRAL, CINAHL, EMBASE, Hooked on Evidence, PEDro, PsycINFO and PubMed).

Design: Audit of bibliographic databases.

Methods: Two hundred and eighty-one reports of randomised controlled trials of physiotherapy interventions were identified by screening the reference lists of 30 relevant systematic reviews published in four consecutive issues of the Cochrane Database of Systematic Reviews (Issue 3, 2007 to Issue 2, 2008).

Rehabilitation after lumbar disc surgery: an update Cochrane review.

Study Design: Cochrane systematic review of randomized controlled trials.

Objective: To evaluate the effects of active rehabilitation for adults after first-time lumbar disc surgery.

Summary Of Background Data: Several rehabilitation programs are available for individuals after lumbar disc surgery, however, little is known about the efficacy of these treatments.

Systematic review of cross-cultural adaptations of McGill Pain Questionnaire reveals a paucity of clinimetric testing.

Objectives: The objectives of this study were to identify the available cross-cultural adaptations of the McGill Pain Questionnaire (MPQ), to describe the clinimetric testing that has occurred for each adaptation and to evaluate both the quality of the adaptation procedures and the clinimetric testing for each version.

Study Design And Setting: This study is a systematic review. Searches of the MEDLINE, EMBASE, and CINAHL databases were used to identify relevant studies.

A guide to interpretation of studies investigating subgroups of responders to physical therapy interventions.

Many researchers and clinicians believe the effectiveness of existing physical therapy interventions can be improved by targeting the provision of specific interventions at patients who respond best to that treatment. Although this approach has the potential to improve outcomes for some patients, it needs to be implemented carefully because some methods used to identify subgroups can produce biased or misleading results. The aim of this article is to assist readers in assessing the validity and generalizability of studies designed to identify subgroups of responders to physical therapy interventions.

Individual, physical and psychological risk factors for neck pain in Australian office workers: a 1-year longitudinal study.

Neck pain is more prevalent in office workers than in the general community. To date, findings from prospective studies that investigated causal relationships between putative risk factors and the onset of neck pain in this population have been limited by high loss to follow-up. The aim of this research was to prospectively evaluate a range of risk factors for neck pain in office workers, using validated and reliable objective measures as well as attain an estimate of 1-year incidence.