Establish the positive predictive value of clinical examination predicted radicular level to MRI. To identify the value of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) assessment tool in the assessment of patients presenting with radicular symptoms of lumbar spine source. 8 patients attending the ESP Orthopaedic triage service, presenting with radicular pain in which MRI is clinically indicated. Prospective study on patients attending ESP Orthopaedic triage service Patients were clinically examined, both parts LANSS score was completed. Following the assessment a radicular level was selected. Following MRI the results were compared. Positive predicted values (PPV) for clinical examination and sensitivity and specificity of a LANSS score>12 was calculated. LANSS score MRI report. PPV of 75% of therapist predicted level being same level or adjacent level to MRI stated level. 66% specificity and 100% sensitivity of patients in study with LANNS>12 having MRI evaluated radicular nerve root compression. This pilot suggests that clinical examination and the LANSS score is useful in establishing the presence of radicular nerve root compression. This evidence supports the need for further research.
Research literature suggests sub classification of LBP may improve clinical outcome. Audit aim is to evaluate the outcome of treatment pathways according to sub classification. Patients had standardised assessment and completed Oswestry Disability Index (ODI) and Hospital Anxiety and Depression Scale (HAD) following assessment and on discharge. Patients were subgrouped into; non specific LBP, radicular pain, LBP with high psychosocial indicators. Patients were allocated to 3 treatment pathways; individual treatment, functional Back class, back care programme. 200 adult patients referred to physiotherapy for low back pain. Exclusion criteria; red flag presentation, patient requiring advice only (n=38). Pre treatment and post treatment HAD, ODI Of 162 patients Individual treatment, 87 (40%)Functional Back Class, 41 (19%) Back Care Programme, 34 (16%). Each pathway demonstrated a clinically significant change in outcome measures. Patient's achieved an average change of between 11 – 17% dependant on pathway. This suggests that the sub classification criteria used allowed the correct pathway choice for patients conditions.
To evaluate the patient experience of patients referred to the ESP Orthopaedic Triage Service. To identify the demographic data of the patients To evaluate patients' expectations and satisfaction of the service A prospective audit of 50 new patients to the ESP service in Mountain Ash General Hospital and Prince Charles Hospital The audit was carried out over a 3 month period between December 2008 and February 2009. Patients were asked to anonymously complete a survey following their appointment. Data was collated independently and analysed with descriptive statistics. Patients referred to ESP service Self administered satisfaction survey. Mean age range 40-59 yrs (range 20 -70yrs). 50% >1 year duration of symptoms. 94% of patient's surveyed rated the service provided as good - excellent. 88% of patient's reported that they were happy to be assessed by the ESP. 96% of patients surveyed agreed they were able to discuss their treatment openly with only 10% preferring to see a Doctor. The ESP service in Cwm Taff Health board achieves a high level of patient satisfaction.
