Table 5 Data extraction for classification systems: Systems classifying by Treatment based approach
From: Classification of patients with low back-related leg pain: a systematic review
Primary Author | Purpose | Method of Development | Domain of Interest | Specific Exclusions | Categories | Criteria used | Training/Personnel needed |
|---|---|---|---|---|---|---|---|
Delitto et al. (2012) [48] | Classify and define musculoskeletal conditions using the World Health Organisation terminology related to International Classification of Functioning, Disability and Health. | Judgement approach. Content experts appointed by Orthopaedic section of the American Physical Therapy Association. | LBP. | Serious medical conditions. | 1: Lumbosacral segmental/somatic dysfunction with mobility deficits 2: Spinal instabilities with movement coordination impairments 3: Flatback syndrome or lumbago due to displacement of disc 4: Of acute low back pain with related (referred) lower extremity pain 5: Lumbago with sciatica 6: Low back pain/strain/lumbago  -with related cognitive or affective tendencies 7: Of chronic LBP with related generalized pain Additional axis-Yes-acute, subacute, chronic | Patient history and clinical examination. Questionnaires for category with related cognitive or affective tendencies. | None. |
Hall et al. (1994) [55] | Identify typical patterns of pain and determine treatment direction. | Judgement approach. Spinal surgeon and physical therapist authorship. | LBP. | None. | 1: LBP +/- referred pain aggravated by flexion, slow onset lasting weeks 2: LBP +/- referred pain aggravated by extension, sudden onset lasts 1–2 weeks 3: Leg dominant pain due to nerve involvement, aggravated by flexion, slow onset, lasts weeks 4: Leg dominant pain due to nerve involvement aggravated by activity and extreme sustained extension, relieved by rest. Rapid onset 5: Abnormal pain behaviour, chronic pattern associated work/sleep/psycho/social issues Additional Axis- No | Patient history and clinical presentation. | None. |
McKenzie (1981) [49] | Develop a classification to determine choice of treatment. | Judgement approach. Physiotherapy authorship. | LBP. | Constant pain, serious pathology, neurological deficit. | 1: Postural 2: Dysfunction 3: Derangement 1–7 | Patient history and clinical examination. | Training in McKenzie assessment desired. |
Albert et al. 2012 [61] | Examine the association between treatment outcome and baseline type of disc lesion. | Judgement approach. Physiotherapy authorship. | Radicular pain with dermatomal distribution to knee or below. 176 patients with sciatica involved in large RCT. | >65 years old, leg pain < 3 on 1–10 scale, duration < 2 weeks or > 1 year, red flags, previous back surgery, serious comorbidities. | 5 groups based on their pain response: 1: Abolition centralization 2: Reduction centralization 3: Unstable centralization 4: Peripheralization 5: No change | Response to repeated moving testing. Lumbar magnetic resonance imaging (MRI). | Training from McKenzie accredited physiotherapist. |