Skip to main content

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.