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Table 2 Shows the percentage of participants who responded “positively predictive” to the list of patient characteristics that may help predict instantaneous relief from NSLBP following SMT

From: Predictors of instantaneous relief from spinal manipulation for non-specific low back pain: a delphi study

No.

A list of patient characteristics that could help predict instantaneous relief from LBP following SMT

Percentage of participants who responded that the item is positively predictive (%)

Round 1

Round 2

Round 3

1.

Duration of symptoms < 16 days

94

94

88

2.

Morning stiffness 30 mins

94

69

3.

A history including a good response to previous spinal manipulation

94

100

100

4.

Good patient-practitioner relationship

94

94

100

5.

No symptoms distal to the knee

88

88

82

6.

Patient has an acute condition (<  14 days)

88

94

82

7.

Professional opinion of health status - excellent/ very good

88

94

94

8.

Fear Avoidance Beliefs Questionnaire work scale score less than 19 out of a high of 42 (low fear category)

81

81

88

9.

Professional opinion of health status – good

81

88

82

10

Patient has a comprehensive understanding of condition

81

75

82

11.

Hypomobility in the lumbar spine

75

69

12.

Pain improves with exercise, but not rest

75

88

88

13.

Patient has a sub-acute condition (15 days to 3 months)

75

56

14.

Age 31–49

75

63

15.

Decreased active range of motion

75

81

82

16.

Pain intermittently during the day

69

63

17.

Previous episode of non-specific LBP in patient history

69

38

18.

Decreased passive range of motion

69

75

82

19.

No symptoms in the lower extremities

69

81

94

20.

Pain severity rated 5/10

69

69

21.

Experiences stiffness after rest (gel phenomenon)

63

44

22.

Pain associated with getting out of a chair

63

44

23.

Pain affecting activities of daily living

63

44

24.

Pain associated with bending forward a little

56

38

25.

Pain associated with arching backwards

56

69

 

26.

Age 10–30

56

44

27.

Recurrent attack of pain

50

38

28.

First episode of pain

50

25

29.

Pain associated with standing for a while

44

38

30.

Pain associated with lifting

44

13

31.

Pain associated with bending forward as far as they can

44

31

32.

Age 50+

44

19

33.

Pain on waking, duration 30 mins

38

13

34.

At least one hip with > 35 degrees of internal rotation

31

13

35.

Pain on waking, duration > 30 mins

31

19

36.

Pain associated with repetitive bending

31

6

37.

Pain associated with running

31

19

38.

Patient BMI < 35

31

13

39.

Patient responds well to anti-inflammatory medicine

31

25

40.

Pain severity rated > 5/10

31

19

41.

Pain associated with doing or attempting to do a sit up

25

42.

Pain associated with driving long distances

25

43.

Female

25

44.

Male

25

45.

Pain present at all times

19

46.

Pain develops later in the day

19

47.

Pain associated with coughing or sneezing

19

48.

Morning stiffness > 30 mins

15

49.

Pain wakes the patient at night

13

50.

Patient has a chronic condition (>  3 months)

13

51.

Patient BMI ≥ 35

13

52.

Professional opinion of health status – fair/poor

7

53.

Patient experiencing depression

7

54.

Patient experiences anxiety

7

55.

Patient is stressed

7

56.

Pain onset related to a specific physical activity

n/a

56

57.

The production of a clicking sound (cavitation) at the moment of thrust

n/a

81

76

58.

Taking a comprehensive history

n/a

75

65

59.

Practitioner understanding of patient expectations and goals

n/a

88

94

60.

Close reproduction of symptoms on spinal springing and/ or end range loading

n/a

81

76

61.

Patient susceptible to placebo effect

n/a

88

88

62.

Patient has trust and confidence in the practitioner

n/a

81

100

  1. Key: n/a: scores for these items are not available in Round 1 as they were added in Round 2 based on suggestions provided by participants in Round 1.
  2. -: items that did not get scored as they had been removed from the survey.