A PHYSIOTHERAPY DELPHI CONSENSUS ON THE IMPORTANT DISCRIMINATORY FEATURES OF NON-SPECIFIC LOW BACK PAIN

Abstract

Introduction Non-specific low back pain (NSLBP) is an extremely heterogeneous condition with many attempts at sub-classification having been made over the years.

Background and Purpose of the Study This study developed UK physiotherapy, professional consensus on the items to be included in a list of important “discriminatory” examination features. These features will be subsequently tested in a large cluster analysis with a view to generating a valid sub-classification of NSLBP.

Material and Method Thirty UK Chartered Physiotherapists, representatives from Clinical Interest Groups, attended a focus group and subsequently undertook a Delphi consensus technique. Participants were purposively sampled from all clinical interest groups to represent as broad a clinical experience as possible. The focus group established the areas of the examination that were to be included in the Delphi process. The Delphi consensus process involved an initial round of statement generation. The physiotherapists were asked to list the examination items, from the history and physical examinations that they rated as important discriminators of different “types” of NSLBP. A content analysis was undertaken to establish common features within the statements and the examination features were then rated for inclusion in the list. A priori, consensus was considered to have been gained when > 80% of participants agreed on inclusion of an examination feature and following a third round of rating consensus was achieved.

Results Eighty examination items were included in the list by participants, following three rounds of the Delphi technique. Fifty items were from the history and thirty items from the physical examination. Items included were from the biomedical, psychological and social domains.

Conclusion This study provides valuable insight into the items of the clinical examination considered important in the discrimination of sub-groups of NSLBP by UK physiotherapists.