A Preliminary Analysis of Outcomes and End Range Procedures Used to Achieve Centralization in People with Low Back Pain
Journal of Manual & Manipulative Therapy. Volume 26, Issue 1, Pages 43-51.
Objectives: To investigate the relationship between clinical outcome and the types of end range procedures used to achieve centralization in a sample of patients with low back pain (LBP) and/or peripheral symptoms.
Methods: Small sample retrospective analysis of an observational cohort. Patients with LBP who centralized during initial visit at two physical therapy clinics were recruited to participate. The types of end range procedures used to achieve centralization were documented during each office visit and a chart review was performed after 4 weeks. Outcomes were determined by improvement in the Oswestry Disability Index (ODI) score after 4 weeks. Statistical analysis determined the association between the types of end range procedures and outcomes.
Results: Thirty-one patients gave consent to participate. Nineteen patients met inclusion criteria and were included in data analysis. After 4 weeks, the improvement in mean ODI scores was 15.89 ± 16.28. Differing end range procedures were used to achieve centralization within this cohort. The types of end range procedures used to achieve centralization were not significantly associated with outcomes.
Discussion: The results observed in this study promote exhausting many different types of end range procedures to determine if centralization can be achieved. Limiting the end range procedures used to assess centralization may fail to identify patients who can achieve centralization and subsequently have positive clinical outcomes. Larger cohort studies investigating relationships between outcomes and the types of end range procedures used to achieve centralization would contribute to management of people with LBP.
Level of Evidence: 4.
centralization, centralization assessment, outcomes, prognosis, end range procedures, back pain, treatment classification systems
Stowell, T., Schenk, R., Hellman, M., & Ladeira, C. (2018). A Preliminary Analysis of Outcomes and End Range Procedures Used to Achieve Centralization in People with Low Back Pain. The Journal of Manual & Manipulative Therapy, 26(1), 43-51. https://doi.org/10.1080/10669817.2017.1370521