Feasibility of using Treatment based Classification System to Plan Management of Patients with Low Back Pain

Abstract

Background: Low back pain (LBP) is an extremely common symptom and most troublesome of complaints in the general population. Pain can vary from a dull constant ache to a sudden sharp feeling. At any point in time 80% of general population will experience some type of low back pain1. Treatment efficacy for the increasing prevalence of this back pain is a great challenge for both health care providers and individuals coping with this problem3. In order to select an effective and efficient treatment in daily clinical practice, low back pain patients should be classified by symptoms during testing and physical examination. One of the main classification systems which focus individual clinical presentation is treatment based classification system. Treatment based classification system will also have impact on clinical decision-making in the management of low back pain3. Objectives: To educate all therapist working with patients with back pain to categorize each patients using treatment based classification system. To establish the consistency and accuracy of therapists in using treatment based classification system for patients with LBP. To analyze therapists opinion of the feasibility of treatment based classification system to plan the management of LBP. Study design: Observational study Method: A total of 46 patients were recruited in this observational study. Each patients was assessed and allocated to treatment based classification system. Visual analogue scale and Patient-Specific Functional Scale for first and last day of the treatment was taken and number of session also documented by the trained therapist. Results: Results were analysed by the questions obtained from the five therapists. All five agreed for the accuracy in categorization and time, 60% agreed for the consistency in usage and goal setting and only 40% agreement for the usefulness. The total feasibility level was 75%. Conclusion: The study concludes that using TBC system to plan management for low back pain is feasible in terms of categorization, accuracy and time but not cost effectiveness.