Physiotherapy and low back pain - part 1 outcomes research in the quest for evidence

Abstract

Low back pain (LBP) is one of the most common and costly conditions treated by physiotherapists and is acknowledged as a major health problem. Much published research on LBP is of poor design and optimal outcome measures are not selected for LBP patients. Effective and cost-effective interventions for LBP, particularly chronic LBP, need to be identified using appropriate, valid, reliable and responsive measures of outcome. These outcome measures should reflect the biopsychosocial model necessary for evaluating the broad impact of LBP, in particular chronic LBP, on a patient’s life. Outcomes research is a feasible and affordable analysis of clinical practice as it occurs, and provides an opportunity to evaluate the effectiveness of interventions for LBP. This is in contrast to a randomised, controlled trial (RCT) that evaluates efficacy under controlled conditions that often do not reflect clinical practice. Using a battery of outcome measures appropriate for measuring change in the LBP population, outcomes research has the potential to identify effective and cost-effective interventions, promote and influence further research, and contribute to the demand for evidence-based practice.

Keywords

• low back pain
• outcomes research
• evidennce-based practice
• outcomes measures
• biopsychosocial model
• effectiveness
• efficacy