Adriaan Louw1,2,3, Steve Goldrick1,3,4, Andrew Bernstetter5, Leonard H Van Gelder6, Aaron Parr7, Kory Zimney1,3,8, Terry Cox1,9. 1. International Spine Pain Institute , Story City, IA, USA. 2. Department of Physical Therapy, St. Ambrose University , Davenport, IA, USA. 3. Pain Science Fellowship, Evidence in Motion , San Antonio, TX, USA. 4. Kitsap Physical Therapy , Silverdale, WA, USA. 5. Kent Outpatient Physical Therapy , Kent, WA, USA. 6. Dynamic Principles L.L.C , Grand Rapids, MI, USA. 7. ProActive Physical Therapy , Tucson, AZ, USA. 8. Department of Physical Therapy, University of South Dakota , Vermillion, SD, USA. 9. Department of Physical Therapy, Southwest Baptist University , Bolivar, MO, USA.
Abstract
Objective: To investigate the effect of the examination process (history taking and physical examination) on pain and function. Methods: An observational cohort trial of patients presenting to outpatient physical therapy clinics for the first time with low back pain (n = 34, 57.7 ± 18.7 years, 53% female). A blinded investigator measured participants prior to the beginning of the initial evaluation and after each component of evaluation (history taking and physical examination). Another physical therapist provided normal history taking and physical examination as the patient case presented itself. Primary outcome measure was numeric pain rating scale (NPRS) for the low back and leg. Secondary outcomes and time during examination process and connection between PT and patient were also measured as potential confounders. Results: Participants showed a significant reduction in pain through just the history taking and physical exam for both the back with an NPRS reduction of 1.23 and the leg showing a 0.95 NPRS reduction. The most significant reduction occurs after history taking. Discussion: The evaluation process produced small, but significant, therapeutic effects related to pain, fear-avoidance, pain catastrophization, and functional measures of mobility and sensitivity. The therapist's report of connection with the patient did not alter the patient outcome.
Objective: To investigate the effect of the examination process (history taking and physical examination) on pain and function. Methods: An observational cohort trial of patients presenting to outpatient physical therapy clinics for the first time with low back pain (n = 34, 57.7 ± 18.7 years, 53% female). A blinded investigator measured participants prior to the beginning of the initial evaluation and after each component of evaluation (history taking and physical examination). Another physical therapist provided normal history taking and physical examination as the patient case presented itself. Primary outcome measure was numeric pain rating scale (NPRS) for the low back and leg. Secondary outcomes and time during examination process and connection between PT and patient were also measured as potential confounders. Results:Participants showed a significant reduction in pain through just the history taking and physical exam for both the back with an NPRS reduction of 1.23 and the leg showing a 0.95 NPRS reduction. The most significant reduction occurs after history taking. Discussion: The evaluation process produced small, but significant, therapeutic effects related to pain, fear-avoidance, pain catastrophization, and functional measures of mobility and sensitivity. The therapist's report of connection with the patient did not alter the patient outcome.
Entities:
Keywords:
Physical examination; medical history taking; musculoskeletal pain; physical therapy