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DOI: 10.1055/s-0029-1245652
© Georg Thieme Verlag KG Stuttgart · New York
Kann zentralisierender Schmerz bei der Erstuntersuchung den Behandlungserfolg bei Erwachsenen mit LWS-Beschwerden vorhersagen?
Sekundäre Analyse einer randomisierten kontrollierten Studie mit 1-jährigem Follow-upDoes Centralising Pain on the Initial Visit Predict Outcomes in Adults with Low Back Pain?A Secondary Analysis of a Randomised Controlled Trial with 1-Year Follow-upPublication History
Manuskript eingetroffen: 6.1.2010
Manuskript akzeptiert: 3.3.2010
Publication Date:
14 September 2010 (online)

Zusammenfassung
Bisher ließ sich vom in mehreren aufeinanderfolgenden Untersuchungen bestimmten Zentralisationsphänomen eine gute Prognose ableiten, wohingegen eine Nichtzentralisation chronische Kreuzschmerzen und Behinderung vorhersagte.
Diese Studie ging der Frage nach, ob bei der Erstuntersuchung festgestellte zentralisierende Rückenschmerzen in der LWS (LBP) ein besseres Behandlungsresultat vorhersagen als nicht zentralisierende LBP. Dazu wurden die 134 erwachsenen Studienteilnehmer in 3 Behandlungsgruppen eingeteilt: orthopädische Manuelle Therapie, McKenzie-Methode und Ratschläge, aktiv zu bleiben.
Insgesamt zeigten bei der Erstuntersuchung festgestellte zentralisierende LBP tendenziell bessere und langfristigere Vorhersagen.
Abstract
A number of consecutive studies have shown that certain centralisation phenomena indicate a good prognosis whereas non-centralisation predicts chronicification of low back pain and disability.
This study examined whether centralising low back pain (LBP) defined at the initial assessment and treatment session might predict better treatment outcomes than non-centralising LBP. For this purpose the 134 adult study participants were allocated to 3 treatment groups: orthopaedic manual therapy, McKenzie method and advice to stay active. In general centralising LBP defined on the initial visit tended to predict better and longer lasting prognosis.
Schlüsselwörter
Zentralisationsphänomen - Nicht-Zentralisationsphänomen - Behinderung - Rückenschmerzen
Key words
centralisation phenomenon - non-centralisation phenomenon - disability - low back pain
Literatur
- 1
Aina A, May S, Clare H.
The centralization phenomenon of spinal symptoms a systematic review.
Man Ther.
2004;
9
134-143
MissingFormLabel
- 2
Airaksinen O, Brox J I, Cedraschi C et al.
European guidelines for the management of chronic non-specific low back pain.
Eur Spine J.
2006;
S2
192-300
MissingFormLabel
- 3
Bybee R, Hipple L, McConnell R et al.
The relationship between reported pain during movement and centralization of symptoms
in low back pain patients.
manuelletherapie.
2005;
9
122-127
MissingFormLabel
- 4
Donelson R, Silva G, Murphy K.
Centralization phenomenon. Its usefulness in evaluating and treating referred pain.
Spine.
1990;
15
211-213
MissingFormLabel
- 5
Fritz J M, Delitto A, Vignovic M et al.
Interrater reliability of judgements of the centralization phenomenon and status change
during movement testing in patients with low back pain.
Arch Phys Med Rehab.
2000;
81
57-61
MissingFormLabel
- 6
Hefford C.
McKenzie classification of mechanical spinal pain: profile of syndromes and directions
of preference.
Man Ther.
2008;
13
75-81
MissingFormLabel
- 7 Hicks C M (ed).. Research methods for clinical therapists. Applied project design and analysis. Churchill Livingstone/Harcourt. New York; 2000 3 rd ed
MissingFormLabel
- 8 Jacobsen B S. Organizing and displaying data. In Munro Hazard B, (ed) Statistical methods for health care research.. 3 rd ed. Philadelphia: Lippincott-Raven; 1997
MissingFormLabel
- 9
Jordan K, Dunn K M, Lewis M et al.
A minimal clinically important difference was derived for the Roland-Morris disability
questionnaire for low back pain.
J Clin Epidemiol.
2006;
59
45-52
MissingFormLabel
- 10
Kilpikoski S, Airaksinen O, Kankaanpää M et al.
Interexaminer reliability of low back pain assessment using the McKenzie method.
Spine.
2002;
27
E207-E214
MissingFormLabel
- 11
Kilpikoski S, Alen M, Paatelma M et al.
Outcome comparison among working adults with centralizing low back pain. Secondary
analysis of a randomized controlled trial with 1-year follow-up.
Advances in Physiotherapy.
2009;
DOI: 10.1080 / 14 038 190 902963 087
MissingFormLabel
- 12
Long A L.
The centralization phenomenon. Its usefulness as a predictor of outcome in conservative
treatment of chronic low back pain (a pilot study).
Spine.
1995;
20
2513-2521
MissingFormLabel
- 13
Long A, Donelson R, Fung T.
Does it matter which exercise? A randomized controlled trial of exercise for low back
pain.
Spine.
2004;
29
2593-2602
MissingFormLabel
- 14 McKenzie R A, May S. The lumbar spine mechanical diagnosis and therapy. (eds). Spinal Publication. Waikanae; 2003
MissingFormLabel
- 15
Ostelo R W, Vet H C.
Clinically important outcomes in low back pain.
Best Pract Res Clin Rheumatol.
2005;
19
593-607
MissingFormLabel
- 16
Paatelma de M, Kilpikoski S, Simonen R et al.
Orthopaedic manual therapy, McKenzie method or advice only for low back pain in working
adults: A randomized controlled trial with one year follow-up.
J Rehabil Med.
2008;
40
858-863
MissingFormLabel
- 17
Ratzmjou H, Kramer J F, Yamada R.
Inter-tester reliability of the McKenzie evaluation in mechanical low back pain.
JOSPT.
2000;
30
368-383
MissingFormLabel
- 18
Roland M, Fairbank J.
The Roland-Morris Disability Questionnaire and the Ostwestry Disability Questionnaire.
Spine.
2000;
25
3115-3124
MissingFormLabel
- 19
Scott J, Huskisson E.
Vertical and horizontal visual analogue scales.
Ann Rheum Dis.
1978;
38
560-565
MissingFormLabel
- 20
Skytte L, May S, Petersen P.
Centralization: Its prognostic value in patients with referred symptoms and sciatica.
Spine.
2005;
30
E293-E299
MissingFormLabel
- 21
Van Tulder M, Becker A, Bekkering T et al.
European guidelines for the management of acute non-specific low back pain in primary
care.
Eur Spine J.
2006;
S2
169-191
MissingFormLabel
- 22
Werneke M, Hart D L.
Centralization phenomenon as a prognostic factor for chronic low back pain and disability.
Spine.
2001;
26
758-765
MissingFormLabel
- 23
Werneke M, Hart D L.
Discriminant validity and relative precision of classifying patient with non-specific
neck and back pain by anatomic pain patterns.
Spine.
2003;
28
161-166
MissingFormLabel
- 24
Werneke M, Hart D L, Resnik L et al.
Centralization: prevalence and effect on treatment outcomes using a standardized operational
definition and measurement method.
JOSPT.
2008;
38
116-125
MissingFormLabel
Sinikka Kilpikoski
MSc PT
Savonmäentie 15
40800 Vaajakoski
Finnland
Email: sinikka.kilpikoski@kolumbus.fi