Efficacy of Directional Preference Management for Low Back Pain: A Systematic Review

Providing specific treatment based on symptom response for people with low back pain (LBP) and a directional preference (DP) is a widely used treatment approach. The efficacy of treatment using the principles of directional preference management (DPM) for LBP is unclear.  The purpose of this systematic review was to determine the efficacy of treatment using the principles of DPM for people with LBP and a DP.  Only RCTs investigating DPM for people with LBP and a DP were included. Outcomes for pain, back specific function, and work participation were extracted.  Six RCTs were included in this review. Five were considered high quality. Clinical heterogeneity of the included trials prevented meta-analysis. GRADE quality assessment revealed mixed results; however, moderate evidence was identified that DPM was significantly more effective than a number of comparison treatments for pain, function, and work participation at short-term, intermediate-term, and long-term follow-ups. No trials found that DPM was significantly less effective than comparison treatments.

Although this systematic review showed mixed results, some evidence was found supporting the effectiveness of DPM when applied to participants with a DP, particularly at short-term and intermediate-term follow-ups. Further high-quality RCTs are warranted to evaluate the effect of DPM applied to people with LBP and a DP.

Surkitt, L. D., Ford, J. J., Hahne, A. J., Pizzari, T., McMeeken, J. M.. Efficacy of Directional Preference Management for Low Back Pain: A Systematic Review. Physical Therapy, May 2012 vol. 92 no. 5 652-665

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.
Research article posted by: Rachael Lowe

Rachael Lowe is Co-Founder and Executive Director of Physiopedia. A physiotherapist and technology specialist Rachael has been working with Physiopedia since 2008 to create a resource that provides universal access to physiotherapy knowledge as well as a platform for connecting and educating the global physiotherapy profession.

Speak Your Mind

*