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Outcome Measures in the Management of Low Back Pain-A Systematized Review
Acharya Jahnavi Jagadish1, Kalashree Hadya Ananda1
1JSS College of Physiotherapy, Mysore, India.
Background:
Low back pain (LBP) is a prevalent condition that affects a significant portion of the population, leading to substantial healthcare costs and impact on quality of life. Effective management of LBP requires robust outcome measures to assess the efficacy of various treatment modalities.
Objective:
This systematized review aimed to identify and evaluate the outcome measures used in the management of low back pain, focusing on their validity, reliability, sensitivity, and clinical relevance.
Methods:
A comprehensive search of electronic databases, including PubMed, was conducted to identify studies that assessed the measurement properties of outcome measures used in the management of LBP. Data extraction focused on the types of outcome measures used and their psychometric properties. Data analysis was done after quantitatively pooling based on COSMIN guidelines.
Results:
The database search and reference check resulted in 808 unique abstracts, of which 240 were assessed for full text eligibility. Ultimately, 124 articles describing 56 unique PROM's measuring different proposed domains were included in this systematized review. The review identified a range of outcome measures employed in LBP management under each proposed domain based on the millennial recommendations. This review also mentioned several new outcome measures such as Physical activity decline (PAD) score, Backache Disability Index (BADIX), Working Alliance Inventory (WAI), return-to-work self-efficacy (RTWSE-19) questionnaire, The NIH task force's minimum data set and World Health Organisation Disability Assessment Schedule (WHODAS 2.0) with sufficient measurement properties. This review highlighted gaps in the sensitivity of some measures to detect clinically meaningful changes and emphasized the need for standardization in outcome reporting.
Interpretation And Conclusion:
Effective management of LBP relies on the use of validated and reliable outcome measures. While traditional PROM's like the ODI and RMDQ remain prevalent, emerging tools may offer enhanced sensitivity and comprehensiveness. Future research should aim to standardize outcome measures and assess their psychometric properties to facilitate comparisons across studies and improve the quality of evidence in LBP management.
