Clinical prediction rule to identify low back pain patients most likely to benefit from spinal manipulation
This clinical prediction rule concerns patiënts with low back pain. Patients that meet at least 4 of the 5 criteria are most likely to benefit from spinal manipulation. 
Research authors: John D. Childs, Julie M. Fritz, Timothy W. Flynn, James J. Irrgang, Kevin K. Johnson, Guy R. Majkowski, Anthony Delitto
Details Formula Study characteristics Files & References
Model author
Model ID
Revision date
MeSH terms
  • Low Back Pain
  • Spinal Manipulation
  • Physiotherapy (Techniques)
  • Clinical Prediction Rule
  • Model type
    Linear model (Calculation)
    No Formula defined yet
    Condition Formula

    Additional information

    Patients from 8 clinics were recruited in various U.S. regions from March 2002 through March 2003. 543 consecutive patients were screened who were referred to physical therapy with symptoms of low back pain for inclusion. Of these, 386 did not meet all inclusion criteria. The most common reasons for exclusion were an ODQ score less than 30% (n = 202 [53%]) and age younger than 18 years or older than 60 years (n = 64 [17%]). Of 157 eligible patients, 26 elected not to participate because of concerns about the time commitment (n = 19) or not wanting to be randomly assigned to 1 of the treatment groups (n = 7). The remaining 131 patients provided informed consent and were enrolled. After randomization, 70 patients were assigned to the manipulation group and 61 to the exercise group.

    Study Population

    Total population size: 131
    Males: {{ model.numberOfMales }}
    Females: {{ model.numberOfFemales }}

    Continuous characteristics

    Name Mean SD Unit
    Age 33.9 10.9 years
    Body mass index 27.1 4.5 kg/m2
    FABQ physical activity subscale score 17 4.3 points
    FABQ work subscale score 17.0 10.3 points
    ODQ score 41.2 10.4 points
    Pain 5.8 1.6 points

    Categorical characteristics

    Name Subset / Group Nr. of patients
    Characteristics Current smokers 30
    previous improvement with manipulation for low back pain 29
    Medication use for low back pain 110
    Missed any work for low back pain 52
    Symptoms distal to the knee 31
    History of low back pain 89
    Clinical prediction rule to identify low back pain patients most likely to benefit from spinal manipulation
    Refer to Intended Use for instructions before use
    Evidencio B.V., Irenesingel 19, 7481 GJ, Haaksbergen, the Netherlands

    Related files

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    Supporting Publications

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    Amount of the criteria met from the clinical prediction rule:

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    Outcome stratification

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    Conditional information

    Result interpretation

    The clinical prediction rule identifies patient with low back pain that are most likely to benefit from spinal manipulation. 

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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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