Skip to main content
  • Other Publications
  • Subscribe
  • Contact Us
Advertisement
JCORE Reference
this is the JCORE Reference site slogan
  • Home
  • Most Read
  • About Us
    • About Us
    • Editorial Board
  • More
    • Advertising
    • Alerts
    • Feedback
    • Folders
    • Help
  • Patients
  • Reference Site Links
    • View Regions
  • Archive

Author Response

Muhammad Alrwaily, Michael Timko, Michael Schneider, Joel Stevans, Christopher Bise, Karthik Hariharan, Anthony Delitto
DOI: 10.2522/ptj.2016.96.10.1670 Published 1 October 2016
Muhammad Alrwaily
M. Alrwaily, PT, PhD, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bridgeside Point 1, 100 Technology Dr, Ste 470, Pittsburgh, PA 15219 (USA), and Department of Physical Therapy, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael Timko
M. Timko, PT, MS, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, and Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, West Virginia.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael Schneider
M. Schneider, DC, PhD, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joel Stevans
J. Stevans, DC, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christopher Bise
C. Bise, PT, DPT, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Karthik Hariharan
K. Hariharan, PT, MS, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anthony Delitto
A. Delitto, PT, PhD, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • PDF
Loading

We thank Rosedale et al1 for taking the time to comment on our recently published update of the treatment-based classification (TBC) system for the treatment of patients with low back pain.2 Since its first publication in 1995,3 the primary goal of the TBC has not changed: to provide clinicians with a comprehensive framework with which to select the best possible rehabilitation interventions for our patients. The TBC has always been formulated through pure scientific inquiry and, as such, has been updated regularly with new evidence that informs clinical decision making.2,4

To be clear, our recent version of the TBC is not meant to be a review or commentary on any other classification system. In our most recent assessment of the literature, we note that approaches based on singular treatment paradigms, although effective in some cases, have generally failed to provide the impact necessary to improve the overall clinical management of low back pain.5–15

The most recent update of the TBC framework recognizes the importance of triage, both at the level of the first-contact health care provider and at the level of the rehabilitation provider. Considering treatment-modifying variables, the rehabilitation provider must be able to implement interventions specific to symptom modulation, movement control, and functional optimization. To that end, variables such as psychosocial status and relative medical comorbidities must be assessed, as is the current scientific consensus.16 As always, we look forward to updating the TBC with the most recent evidence from the scientific community.

Footnotes

  • This letter was posted as an eLetter on August 12, 2016, at ptjournal.apta.org.

  • © 2016 American Physical Therapy Association

References

  1. ↵
    1. Rosedale R,
    2. Hoyt K,
    3. Clare H,
    4. Schenk R
    . Letter to the editor on “Treatment-based classification system for low back pain: revision and update.” Phys Ther. 2016;96:1669–1670.
    OpenUrlFREE Full Text
  2. ↵
    1. Alrwaily M,
    2. Timko M,
    3. Schneider M,
    4. et al
    . Treatment-based classification system for low back pain: revision and update. Phys Ther. 2016;96:1057–1066.
    OpenUrlAbstract/FREE Full Text
  3. ↵
    1. Delitto A,
    2. Erhard RE,
    3. Bowling RW
    . A treatment-based classification approach to low back syndrome: identifying and staging patients for conservative treatment. Phys Ther. 1995;75:470–485; discussion 485–479.
    OpenUrlAbstract/FREE Full Text
  4. ↵
    1. Fritz JM,
    2. Cleland JA,
    3. Childs JD
    . Subgrouping patients with low back pain: evolution of a classification approach to physical therapy. J Orthop Sports Phys Ther. 2007;37:290–302.
    OpenUrlCrossRefPubMedWeb of Science
  5. ↵
    1. Billis EV,
    2. McCarthy CJ,
    3. Oldham JA
    . Subclassification of low back pain: a cross-country comparison. Eur Spine J. 2007;16:865–879.
    OpenUrlCrossRefPubMedWeb of Science
  6. ↵
    1. Fairbank J,
    2. Gwilym SE,
    3. France JC,
    4. et al
    . The role of classification of chronic low back pain. Spine (Phila Pa 1976). 2011;36(21 suppl):S19–S42.
    OpenUrlCrossRef
  7. ↵
    1. Hartvigsen J,
    2. Natvig B,
    3. Ferreira M
    . Is it all about a pain in the back? Best Pract Res Clin Rheumatol. 2013;27:613–623.
    OpenUrlCrossRef
  8. ↵
    1. Wand BM,
    2. O'Connell NE
    . Chronic non-specific low back pain: sub-groups or a single mechanism? BMC Musculoskelet Disord. 2008;9:1.
    OpenUrlCrossRefPubMed
  9. ↵
    1. Hayden JA,
    2. van Tulder MW,
    3. Malmivaara AV,
    4. Koes BW
    . Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med. 2005;142:765–775.
    OpenUrlCrossRefPubMedWeb of Science
  10. ↵
    1. Hayden JA,
    2. van Tulder MW,
    3. Tomlinson G
    . Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med. 2005;142:776–785.
    OpenUrlCrossRefPubMedWeb of Science
  11. ↵
    1. Vibe Fersum K,
    2. O'Sullivan P,
    3. Skouen JS,
    4. et al
    . Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: a randomized controlled trial. Eur J Pain. 2013;17:916–928.
    OpenUrlCrossRefPubMedWeb of Science
  12. ↵
    1. Hodges PW,
    2. Cholewicki J,
    3. van Dieën JH
    1. Van Dillen LR,
    2. van Tulder MW
    . Targeting interventions to patients: development and evaluation. In: Hodges PW, Cholewicki J, van Dieën JH, eds. Spinal Control: The Rehabilitation of Back Pain: State of the Art and Science. Edinburgh, United Kingdom: Elsevier Churchill Livingstone; 2013:195–205.
  13. ↵
    1. Fourney DR,
    2. Andersson G,
    3. Arnold PM,
    4. et al
    . Chronic low back pain: a heterogeneous condition with challenges for an evidence-based approach. Spine (Phila Pa 1976). 2011;36(21 suppl):S1–S9.
    OpenUrlCrossRef
  14. ↵
    1. Sheeran L,
    2. Coales P,
    3. Sparkes V
    . Clinical challenges of classification based targeted therapies for non-specific low back pain: what do physiotherapy practitioners and managers think? Man Ther. 2015;20:456–462.
    OpenUrlCrossRefPubMed
  15. ↵
    1. Henry SM,
    2. Van Dillen LR,
    3. Ouellette-Morton RH,
    4. et al
    . Outcomes are not different for patient-matched vs. non-matched treatment in subjects with chronic, recurrent low back pain: a randomized clinical trial. Spine J. 2014;14:2799–2810.
    OpenUrlCrossRefPubMed
  16. ↵
    1. Deyo RA,
    2. Dworkin SF,
    3. Amtmann D,
    4. et al
    . Report of the NIH Task Force on Research Standards for Chronic Low Back Pain. Spine (Phila Pa 1976). 2014;39:1128–1143.
    OpenUrlCrossRef
View Abstract
PreviousNext
Back to top
Vol 96 Issue 10 Table of Contents
Physical Therapy: 96 (10)

Issue highlights

  • Our Future Selves: Unprecedented Opportunities
  • Toward a Transformed Understanding: From Pain and Movement to Pain With Movement
  • Virtual Reality for Stroke Rehabilitation
  • Consensus on Exercise Reporting Template (CERT): Modified Delphi Study
  • Agreement of Mechanical Diagnosis and Therapy Classification in People With Extremity Conditions
  • High-Intensity Interval Training and Moderate-Intensity Continuous Training in Ambulatory Chronic Stroke: Feasibility Study
  • Therapeutic Ultrasound and Treadmill Training Suppress Peripheral Nerve Injury–Induced Pain in Rats
  • A Further Step to Develop Patient-Friendly Implementation Strategies for Virtual Reality–Based Rehabilitation in Patients With Acute Stroke
  • Transitions in the Embodied Experience After Stroke: Grounded Theory Study
  • Neck Posture Clusters and Their Association With Biopsychosocial Factors and Neck Pain in Australian Adolescents
  • Physical Therapists' Role in Health Promotion as Perceived by the Patient: Descriptive Survey
  • Finding the “Right-Size” Physical Therapy Workforce: International Perspective Across 4 Countries
  • Does the Brief-BESTest Meet Classical Test Theory and Rasch Analysis Requirements for Balance Assessment in People With Neurological Disorders?
  • Roland-Morris Disability Questionnaire and Oswestry Disability Index: Which Has Better Measurement Properties for Measuring Physical Functioning in Nonspecific Low Back Pain? Systematic Review and Meta-Analysis
  • Responsiveness of the Balance Evaluation Systems Test (BESTest) in People With Subacute Stroke
  • Use of Rasch Analysis to Evaluate and Refine the Community Balance and Mobility Scale for Use in Ambulatory Community-Dwelling Adults Following Stroke
  • de Morton Mobility Index Is Feasible, Reliable, and Valid in Patients With Critical Illness
Email

Thank you for your interest in spreading the word on JCORE Reference.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Author Response
(Your Name) has sent you a message from JCORE Reference
(Your Name) thought you would like to see the JCORE Reference web site.
Print
Author Response
Muhammad Alrwaily, Michael Timko, Michael Schneider, Joel Stevans, Christopher Bise, Karthik Hariharan, Anthony Delitto
Physical Therapy Oct 2016, 96 (10) 1670-1671; DOI: 10.2522/ptj.2016.96.10.1670

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Save to my folders

Share
Author Response
Muhammad Alrwaily, Michael Timko, Michael Schneider, Joel Stevans, Christopher Bise, Karthik Hariharan, Anthony Delitto
Physical Therapy Oct 2016, 96 (10) 1670-1671; DOI: 10.2522/ptj.2016.96.10.1670
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Article
    • Footnotes
    • References
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • On “Benka Wallén M, Sorjonen K, Löfgren N, Franzén E. Structural validity of the Mini-Balance Evaluation Systems Test (Mini-BESTest) in people with mild to moderate Parkinson disease.” Phys Ther. 2016;96:1799–1806.
  • Author Response
Show more Letters and Responses

Subjects

  • Musculoskeletal System/Orthopedic
    • Injuries and Conditions: Low Back
  • Perspectives
  • Psychosocial
    • Psychosocial: Other
  • Physical Therapist Practice
    • Evidence-Based Practice
    • Clinical Decision Making
  • Diagnosis/Prognosis
    • Classification

Footer Menu 1

  • menu 1 item 1
  • menu 1 item 2
  • menu 1 item 3
  • menu 1 item 4

Footer Menu 2

  • menu 2 item 1
  • menu 2 item 2
  • menu 2 item 3
  • menu 2 item 4

Footer Menu 3

  • menu 3 item 1
  • menu 3 item 2
  • menu 3 item 3
  • menu 3 item 4

Footer Menu 4

  • menu 4 item 1
  • menu 4 item 2
  • menu 4 item 3
  • menu 4 item 4
footer second
footer first
Copyright © 2013 The HighWire JCore Reference Site | Print ISSN: 0123-4567 | Online ISSN: 1123-4567
advertisement bottom
Advertisement Top