Which Patients with Low Back Pain will Respond to a Stabilization Exercise Program?

When treating patients with low back pain, it is sometimes difficult to predict who may benefit from a lumbar stabilization exercise program. Researchers have come up with a list of prediction rules that can help with a physical therapist's decision. Over time, the overall reliability and validity of these rules will be proven to a greater degree.

These clinical prediction rules include:

- age less than 40
- history of frequent prior episodes, with increasing frequency
- frequent manipulation resulting in short-term dramatic results
- history of trauma or spinal surgery
- pregnancy related lumbo-pelvic pain
- radiographic diagnosis of spondylolysis or spondylolisthesis
- reports of "catching" pain and/or painful arc on forward bending or when lifting
- "thigh climbing" upon returning from forward bending
- general hyper-mobility during passive intervertebral motion testing
- reports of feeling "unstable" in the spine during functional activities or when lifting
- straight leg raise test bilaterally greater than 90 degrees
- positive prone instability test

Hicks, Fritz, Delitto, McGill. Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Arch Phys Med Rehabil. 2005 Sep;86(9):1753-62.