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Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocol

BACKGROUND: Low-back related leg pain with or without nerve root involvement is associated with a poor prognosis compared to low back pain (LBP) alone. Compared to the literature investigating prognostic indicators of outcome for LBP, there is limited evidence on prognostic factors for low back-rela...

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Autores principales: Konstantinou, Kika, Beardmore, Ruth, Dunn, Kate M, Lewis, Martyn, Hider, Samantha L, Sanders, Tom, Jowett, Sue, Somerville, Simon, Stynes, Siobhan, van der Windt, Danielle AWM, Vogel, Steven, Hay, Elaine M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293000/
https://www.ncbi.nlm.nih.gov/pubmed/22264273
http://dx.doi.org/10.1186/1471-2474-13-4
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author Konstantinou, Kika
Beardmore, Ruth
Dunn, Kate M
Lewis, Martyn
Hider, Samantha L
Sanders, Tom
Jowett, Sue
Somerville, Simon
Stynes, Siobhan
van der Windt, Danielle AWM
Vogel, Steven
Hay, Elaine M
author_facet Konstantinou, Kika
Beardmore, Ruth
Dunn, Kate M
Lewis, Martyn
Hider, Samantha L
Sanders, Tom
Jowett, Sue
Somerville, Simon
Stynes, Siobhan
van der Windt, Danielle AWM
Vogel, Steven
Hay, Elaine M
author_sort Konstantinou, Kika
collection PubMed
description BACKGROUND: Low-back related leg pain with or without nerve root involvement is associated with a poor prognosis compared to low back pain (LBP) alone. Compared to the literature investigating prognostic indicators of outcome for LBP, there is limited evidence on prognostic factors for low back-related leg pain including the group with nerve root pain. This 1 year prospective consultation-based observational cohort study will describe the clinical, imaging, demographic characteristics and health economic outcomes for the whole cohort, will investigate differences and identify prognostic indicators of outcome (i.e. change in disability at 12 months), for the whole cohort and, separately, for those classified with and without nerve root pain. In addition, nested qualitative studies will provide insights on the clinical consultation and the impact of diagnosis and treatment on patients' symptom management and illness trajectory. METHODS: Adults aged 18 years and over consulting their General Practitioner (GP) with LBP and radiating leg pain of any duration at (n = 500) GP practices in North Staffordshire and Stoke-on-Trent, UK will be invited to participate. All participants will receive a standardised assessment at the clinic by a study physiotherapist and will be classified according to the clinically determined presence or absence of nerve root pain/involvement. All will undergo a lumbar spine MRI scan. All participants will be managed according to their clinical need. The study outcomes will be measured at 4 and 12 months using postal self-complete questionnaires. Data will also be collected each month using brief postal questionnaires to enable detailed description of the course of low back and leg pain over time. Clinical observations and patient interviews will be used for the qualitative aspects of the study. DISCUSSION: This prospective clinical observational cohort will combine self-reported data, comprehensive clinical and MRI assessment, together with qualitative enquiries, to describe the course, health care usage, patients' experiences and prognostic indicators in an adult population presenting in primary care with LBP and leg pain with or without nerve root involvement.
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spelling pubmed-32930002012-03-05 Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocol Konstantinou, Kika Beardmore, Ruth Dunn, Kate M Lewis, Martyn Hider, Samantha L Sanders, Tom Jowett, Sue Somerville, Simon Stynes, Siobhan van der Windt, Danielle AWM Vogel, Steven Hay, Elaine M BMC Musculoskelet Disord Study Protocol BACKGROUND: Low-back related leg pain with or without nerve root involvement is associated with a poor prognosis compared to low back pain (LBP) alone. Compared to the literature investigating prognostic indicators of outcome for LBP, there is limited evidence on prognostic factors for low back-related leg pain including the group with nerve root pain. This 1 year prospective consultation-based observational cohort study will describe the clinical, imaging, demographic characteristics and health economic outcomes for the whole cohort, will investigate differences and identify prognostic indicators of outcome (i.e. change in disability at 12 months), for the whole cohort and, separately, for those classified with and without nerve root pain. In addition, nested qualitative studies will provide insights on the clinical consultation and the impact of diagnosis and treatment on patients' symptom management and illness trajectory. METHODS: Adults aged 18 years and over consulting their General Practitioner (GP) with LBP and radiating leg pain of any duration at (n = 500) GP practices in North Staffordshire and Stoke-on-Trent, UK will be invited to participate. All participants will receive a standardised assessment at the clinic by a study physiotherapist and will be classified according to the clinically determined presence or absence of nerve root pain/involvement. All will undergo a lumbar spine MRI scan. All participants will be managed according to their clinical need. The study outcomes will be measured at 4 and 12 months using postal self-complete questionnaires. Data will also be collected each month using brief postal questionnaires to enable detailed description of the course of low back and leg pain over time. Clinical observations and patient interviews will be used for the qualitative aspects of the study. DISCUSSION: This prospective clinical observational cohort will combine self-reported data, comprehensive clinical and MRI assessment, together with qualitative enquiries, to describe the course, health care usage, patients' experiences and prognostic indicators in an adult population presenting in primary care with LBP and leg pain with or without nerve root involvement. BioMed Central 2012-01-20 /pmc/articles/PMC3293000/ /pubmed/22264273 http://dx.doi.org/10.1186/1471-2474-13-4 Text en Copyright ©2012 Konstantinou et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Study Protocol
Konstantinou, Kika
Beardmore, Ruth
Dunn, Kate M
Lewis, Martyn
Hider, Samantha L
Sanders, Tom
Jowett, Sue
Somerville, Simon
Stynes, Siobhan
van der Windt, Danielle AWM
Vogel, Steven
Hay, Elaine M
Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocol
title Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocol
title_full Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocol
title_fullStr Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocol
title_full_unstemmed Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocol
title_short Clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. The ATLAS study protocol
title_sort clinical course, characteristics and prognostic indicators in patients presenting with back and leg pain in primary care. the atlas study protocol
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293000/
https://www.ncbi.nlm.nih.gov/pubmed/22264273
http://dx.doi.org/10.1186/1471-2474-13-4
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