A Definition of "Flare" in Low Back Pain: A Multiphase Process Involving Perspectives of Individuals With Low Back Pain and Expert Consensus

被引：25

作者：

Costa, Nathalia ^{[1
]}

Ferreira, Manuela L. ^{[2
]}

Setchell, Jenny ^{[1
]}

Makovey, Joanna ^{[2
]}

Dekroo, Tanya ^{[1
]}

Downie, Aron ^{[3
,4
]}

Diwan, Ashish ^{[5
]}

Koes, Bart ^{[6
,7
]}

Natvig, Bard ^{[8
]}

Vicenzino, Bill ^{[1
]}

Hunter, David ^{[2
,9
]}

Roseen, Eric J. ^{[10
]}

-Barr, Eva Rasmussen ^{[11
]}

Guillemin, Francis ^{[12
]}

Hartvigsen, Jan ^{[13
,14
]}

Bennell, Kim ^{[15
]}

Costa, Leonardo ^{[16
]}

Macedo, Luciana ^{[17
]}

Pinheiro, Marina ^{[18
]}

Underwood, Martin ^{[19
]}

Van Tulder, Mauritus ^{[20
]}

Johansson, Melker ^{[21
]}

Enthoven, Paul ^{[22
]}

Kent, Peter ^{[23
]}

O'Sullivan, Peter ^{[23
]}

Suri, Pradeep ^{[24
,25
,26
,27
,28
]}

Genevay, Stephane ^{[29
]}

Hodges, Paul W. ^{[1
]}

机构：

[1] Univ Queensland, Sch Hlth & Rehabil Sci, Brisbane, Qld 4072, Australia

[2] Univ Sydney, Inst Bone & Joint Res, Kolling Inst, Sydney Med Sch, Sydney, NSW, Australia

[3] Univ Sydney, Musculoskeletal Hlth Sydney, Sydney, NSW, Australia

[4] Macquarie Univ, Dept Chiropract, Sydney, NSW, Australia

[5] Univ New South Wales Australia, St George & Sutherland Clin Sch, Dept Orthopaed Surg, Spine Serv, Sydney, NSW, Australia

[6] Erasmus MC, Dept Gen Practice, Rotterdam, Netherlands

[7] Univ Southern Denmark, Ctr Muscle & Joint Hlth, Odense, Denmark

[8] Univ Oslo, Dept Gen Practice, Inst Hlth & Soc, Oslo, Norway

[9] Royal North Shore Hosp, Dept Rheumatol, Sydney, NSW, Australia

[10] Boston Univ, Sch Med, Boston Med Ctr, Dept Family Med, Boston, MA 02118 USA

[11] Karolinska Inst, Dept Neurobiol, Care Sci & Soc, Div Physiotherapy, Stockholm, Sweden

[12] Univ Lorraine, CHRU Nancy, INSERM, CIC1433 Epidemiol Clin, Nancy, France

[13] Univ Southern Denmark, Dept Sports Sci & Clin Biomech, Odense, Denmark

[14] Nord Inst Chiropract & Clin Biomech, Odense, Denmark

[15] Univ Melbourne, Sch Hlth Sci, Dept Physiotherapy, Ctr Hlth Exercise & Sports Med, Melbourne, Vic, Australia

[16] Univ Cidade Sao Paulo, Masters & Doctoral Programs Phys Therapy, Sao Paulo, SP, Brazil

[17] McMaster Univ, Sch Rehabil Sci, Hamilton, ON, Canada

[18] Univ Sydney, Fac Hlth Sci, Sydney, NSW, Australia

[19] Univ Warwick, Warwick Med Sch, Coventry, W Midlands, England

[20] Vrije Univ, Amsterdam Movement Sci Res Inst, Fac Sci, Dept Hlth Sci, Amsterdam, Netherlands

[21] Natl Res Ctr Working Environm, Musculoskeletal Disorders & Phys Workload, Copenhagen, Denmark

[22] Linkoping Univ, Fac Med & Hlth Sci, Dept Med & Hlth Sci, Linkoping, Sweden

[23] Curtin Univ, Dept Physiotherapy & Exercise Sci, Perth, WA, Australia

[24] VA Puget Sound Hlth Care Syst, Seattle Epidemiol Res & Informat Ctr ERIC, Seattle, WA USA

[25] VA Puget Sound Hlth Care Syst, Div Rehabil Care Serv, Seattle, WA USA

[26] Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA

[27] New England Baptist Hosp, Boston, MA USA

[28] Harvard Med Sch, Dept Phys Med & Rehabil, Boston, MA 02115 USA

[29] Geneva Univ Hosp, Fac Med, Div Rheumatol, Geneva, Switzerland

来源：

JOURNAL OF PAIN | 2019年 / 20卷 / 11期

基金：

英国医学研究理事会;

关键词：

Low back pain; flare; flare-up; definition; consensus; TRAJECTORIES; PREVALENCE; RECURRENCE; DISEASE; KNEE;

D O I：

10.1016/j.jpain.2019.03.009

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Low back pain (LBP) varies over time. Consumers, clinicians, and researchers use various terms to describe LBP fluctuations, such as episodes, recurrences and flares. Although "flare" is use commonly, there is no consensus on how it is defined. This study aimed to obtain consensus for a LBP flare definition using a mixed-method approach. Step 1 involved the derivation of a preliminary candidate flare definition based on thematic analysis of views of 130 consumers in consultation with an expert consumer writer. In step 2, a workshop was conducted to incorporate perspectives of 19 LBP experts into the preliminary flare definition, which resulted in 2 alternative LBP flare definitions. Step 3 refined the definition using a 2-round Delphi consensus with 50 experts in musculoskeletal conditions. The definition favored by experts was further tested with 16 individuals with LBP in step 4, using the definition in three scenarios. This multiphase study produced a definition of LBP flare that distinguishes it from other LBP fluctuations, represents consumers' views, involves expert consensus, and is understandable by consumers in clinical and research contexts: "A flare-up is a worsening of your condition that lasts from hours to weeks that is difficult to tolerate and generally impacts your usual activities and/or emotions." Perspective: A multiphase process, incorporating consumers' views and expert consensus, produced a definition of LBP flare that distinguishes it from other LBP fluctuations. (C) 2019 by the American Pain Society

引用

页码：1267 / 1275

页数：9

共 30 条

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