Subgrouping Patients With Low Back Pain: Evolution of a Classification Approach to Physical Therapy

Julie M. Fritz, Joshua A. Cleland, Maj John D. Childs

The development of valid classification methods to assist the physical therapy management of patients with low back pain has been recognized as a research priority. There is also growing evidence that the use of a classification approach to physical therapy results in better clinical outcomes than the use of alternative management approaches.  This Clinical Commentary was written to review a classification system originally proposed by Delitto and colleagues, its evolution and current status, and discuss its implications for the classification of patients with low back pain.  A substantial amount of research has emerged in the years since the introduction of this classification system, including the development of clinical prediction rules, providing new evidence for the examination criteria used to place a patient into a classification, and for the optimal intervention strategies for each classification. New evidence should continually be incorporated into existing classification systems.

J Orthop Sports Phys Ther. 2007, 37(6), 290-302.

Link to Abstract.