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Article ; Online: Improving the management of sciatica.

Koes, Bart W

The Lancet. Rheumatology

2020 Volume 2, Issue 7, Page(s) e372–e373

Language	English
Publishing date	2020-06-25
Publishing country	England
Document type	Journal Article
ISSN	2665-9913
ISSN (online)	2665-9913
DOI	10.1016/S2665-9913(20)30130-2
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Article ; Online: Nonspecific Low Back Pain.

Chiarotto, Alessandro / Koes, Bart W

The New England journal of medicine

2022 Volume 386, Issue 18, Page(s) 1732–1740

MeSH term(s)	Back Pain ; Humans ; Low Back Pain/etiology ; Pain Measurement
Language	English
Publishing date	2022-07-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMcp2032396
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Article ; Online: Nonspecific Low Back Pain. Reply.

Chiarotto, Alessandro / Koes, Bart W

The New England journal of medicine

2022 Volume 387, Issue 5, Page(s) 479–480

MeSH term(s)	Back Pain ; Humans ; Low Back Pain/etiology ; Pain Measurement
Language	English
Publishing date	2022-08-02
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc2207597
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Article ; Online: Biopsychosocial Intervention or Postural Therapy in Patients With Spine Pain.

Zhu, Zhaochen / Chiarotto, Alessandro / Koes, Bart W

JAMA

2023 Volume 329, Issue 16, Page(s) 1408

MeSH term(s)	Humans ; Low Back Pain/etiology ; Low Back Pain/psychology ; Low Back Pain/therapy ; Musculoskeletal Pain/etiology ; Musculoskeletal Pain/psychology ; Musculoskeletal Pain/therapy ; Physical Therapy Modalities/psychology ; Posture
Language	English
Publishing date	2023-04-25
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2023.3059
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Article ; Online: The prevalence, incidence and management of low back pain with radiating leg pain in Dutch general practice: A population-based cohort study in the Rijnmond Primary Care Database.

Khorami, Ahmad Khoshal / Chiarotto, Alessandro / de Schepper, Evelien I T / Bindels, Patrick J E / Koes, Bart W / van den Driest, Jacoline J

European journal of pain (London, England)

2024

Abstract: Background: Radiating leg pain is common in patients with low back pain (LBP). In this study, we aimed to determine the prevalence and incidence of LBP with radiating leg pain in Dutch general practice, and to describe the prescribed medications and ... ...

Abstract	Background: Radiating leg pain is common in patients with low back pain (LBP). In this study, we aimed to determine the prevalence and incidence of LBP with radiating leg pain in Dutch general practice, and to describe the prescribed medications and requested imaging diagnostics. Methods: The Rijnmond Primary Care Database containing over 500,000 primary care patients was used to select patients ≥18 years with LBP with radiating leg pain between 2013 and 2021. Data on patient characteristics, LBP episodes, prescribed medication and requested imaging in the first 3 months of an episode was extracted. Descriptive statistics were used to present patient characteristics and diagnostic/therapeutic interventions. Results: A total of 27,695 patients were included. The total number of LBP with radiating leg pain episodes in these patients was 36,268. In 2021, the incidence and prevalence were 19.1 and 25.7 per 1000 patient years, respectively. In 60% of patients, the episode duration was shorter than 1 month. In 62% of the episodes, patients visited the general practitioner (GP) one to two times. In 59% of the episodes, at least one medication was prescribed, non-steroidal anti-inflammatory drugs (NSAIDs) being the most common one (45%). In approximately 11% of the episodes, additional diagnostic imaging was requested. Conclusion: LBP with radiating leg pain is common in Dutch general practice patients. About 2/3rd were prescribed pain medications. Dutch request few to none diagnostic imaging for these patients which is in line with clinical practice guidelines. Significance: In this new study, we have gained insights into the incidence and prevalence of LBP with radiating leg pain in Dutch general practice. Both remained fairly stable over the study period of 9 years (2013-2021). Overall, the care burden regarding seeking contact with the GPs and the requested diagnostics seem not to be that high. In 62% of the care episodes, there were one or two consultations with the GP, and in 11% of the episodes a diagnostic imaging was requested. Pain medications frequently prescribed (i.e. 2/3rd of the episodes), with NSAIDs being the most common ones.
Language	English
Publishing date	2024-04-04
Publishing country	England
Document type	Journal Article
ZDB-ID	1390424-3
ISSN	1532-2149 ; 1090-3801
ISSN (online)	1532-2149
ISSN	1090-3801
DOI	10.1002/ejp.2269
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Article ; Online: Exercise therapy for treatment of acute non-specific low back pain: a Cochrane systematic review and meta-analysis of randomised controlled trials.

IJzelenberg, Wilhelmina / Oosterhuis, Teddy / Hayden, Jill A / Koes, Bart W / van Tulder, Maurits W / Rubinstein, Sidney M / de Zoete, Annemarie

Archives of physical medicine and rehabilitation

2024

Abstract: Objective: To assess the effectiveness of exercise for acute non-specific low back pain (LBP) versus our main comparisons: 1) sham treatment, and 2) no treatment at short-term (main follow-up time).: Data sources and study selection: A comprehensive ... ...

Abstract	Objective: To assess the effectiveness of exercise for acute non-specific low back pain (LBP) versus our main comparisons: 1) sham treatment, and 2) no treatment at short-term (main follow-up time). Data sources and study selection: A comprehensive search up till November 2021 was conducted in numerous databases for randomised controlled trials (RCTs) on the effectiveness of exercise in adults with acute LBP (< 6 weeks). Studies examining LBP with a specific aetiology were excluded. The primary outcomes were back pain, back-specific functional status and recovery. Data extraction: Two review authors independently conducted the study selection, risk of bias assessment and data extraction. GRADE was used to assess the certainty of the evidence. Data synthesis: We identified 23 RCTs (2674 participants). There is very low-certainty evidence that exercise therapy compared with sham/placebo treatment has no clinically relevant effect on pain (mean difference (MD) -0.80, 95% confidence interval (CI) -5.79 to 4.19; 1 study, 299 participants) and on functional status (MD 2.00, 95% CI -2.20 to 6.20; 1 study, 299 participants) in the short term. There is very low-quality evidence which suggests no difference in effect on pain and functional status for exercise vs. no treatment (2 studies; n=157, not pooled due to heterogeneity) at short-term follow-up. Similar results were found for the other follow-up moments. The certainty of the evidence was downgraded because many RCTs had a high risk of bias, were small in size and/or there was substantial heterogeneity. Conclusion: Exercise therapy compared to sham/placebo and no treatment may have no clinically relevant effect on pain or functional status in the short term in people with acute non-specific LBP, but the evidence is very uncertain. Owing to insufficient reporting of adverse events, we were unable to reach any conclusions on the safety or harms related to exercise therapy.
Language	English
Publishing date	2024-03-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80057-0
ISSN	1532-821X ; 0003-9993
ISSN (online)	1532-821X
ISSN	0003-9993
DOI	10.1016/j.apmr.2024.02.732
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Article: A Systematic Review of Cardiorespiratory Fitness Tests Used in Dance.

Tiemens, Annemiek / van Rijn, Rogier M / Koes, Bart W / Stubbe, Janine H

Journal of dance medicine & science : official publication of the International Association for Dance Medicine & Science

2023 Volume 27, Issue 1, Page(s) 27–40

Abstract: Dancers need adequate cardiorespiratory fitness (CRF) levels in order to cope with the demands of dance classes and choreographies. Screening and monitoring of CRF is advised. The aim of this systematic review was to provide an overview of tests used to ... ...

Abstract	Dancers need adequate cardiorespiratory fitness (CRF) levels in order to cope with the demands of dance classes and choreographies. Screening and monitoring of CRF is advised. The aim of this systematic review was to provide an overview of tests used to assess CRF in dancers and to examine the measurement properties of these tests. A literature search was performed in three online databases (PubMed, EMBASE, and SPORTDiscus) up until August 16, 2021. Study inclusion criteria were: 1. a CRF test was used; 2. participants were ballet, contemporary or modern, or jazz dancers; and 3. English full-text peer-reviewed article. General study information, participant information, CRF test used, and study outcome were extracted. If available, measurement property data were extracted (i.e., test reliability, validity, responsiveness, and interpretability). Of the 48 articles included in the review, most used a maximal treadmill test (n = 22) or the multistage Dance Specific Aerobic Fitness test (DAFT; n = 11). Out of the 48 included studies, only six examined the measurement properties of CRF tests: Aerobic Power Index (API), Ballet-specific Aerobic Fitness Test (B-DAFT), DAFT, High-Intensity Dance Performance Fitness Test (HIDT), Seifert Assessment of Functional Capactiy for Dancers (SAFD), and the 3-minute step test. Good test-retest reliability was found for the B-DAFT, DAFT, HIDT, and SAFD. Criterion validity was determined for the VO
MeSH term(s)	Humans ; Cardiorespiratory Fitness ; Physical Fitness ; Dancing ; Reproducibility of Results ; Oxygen Consumption
Language	English
Publishing date	2023-05-23
Publishing country	United States
Document type	Systematic Review ; Journal Article
ISSN	1089-313X
ISSN	1089-313X
DOI	10.1177/1089313X231176608
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Article ; Online: Aerobic and Anaerobic Fitness Levels of Pre-Professional Contemporary Dancers: An Exploration of 2 Dance-Specific Field Tests.

Tiemens, Annemiek / van Rijn, Rogier M / Koes, Bart W / Stubbe, Janine H

Journal of dance medicine & science : official publication of the International Association for Dance Medicine & Science

2023 Volume 28, Issue 2, Page(s) 83–89

Abstract: Introduction: The primary aim of this study was to present descriptive heart rate (HR), heart rate recovery (HRR) and RPE data for the DAFT and HIDT within one sample of contemporary dance students. The second aim was to explore if objective (HR) and ... ...

Abstract	Introduction: The primary aim of this study was to present descriptive heart rate (HR), heart rate recovery (HRR) and RPE data for the DAFT and HIDT within one sample of contemporary dance students. The second aim was to explore if objective (HR) and subjective (RPE) data were correlated between tests. Method: 40 (11 males, 29 females) university dance students with a mean age of 18.8 ± 1.8 years performed the DAFT and HIDT on 2 separate occasions within 1 week. Measurements were HR after 4 minutes in all stages of the DAFT, the percentage of age-predicted maximal HR (%HR Results: HR Conclusion: Although the DAFT and HIDT differ in intensity and work-to-rest ratio, there were high correlations between HR and HRR data of both tests and both tests reached intensities above the anaerobic threshold (%HR
MeSH term(s)	Humans ; Dancing/physiology ; Female ; Male ; Heart Rate/physiology ; Adolescent ; Young Adult ; Physical Exertion/physiology ; Anaerobic Threshold/physiology ; Exercise Test/methods ; Physical Fitness/physiology
Language	English
Publishing date	2023-11-25
Publishing country	United States
Document type	Journal Article
ISSN	2374-8060
ISSN (online)	2374-8060
DOI	10.1177/1089313X231213139
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Article ; Online: External validation and updating of prognostic models for predicting recovery of disability in people with (sub)acute neck pain was successful: broad external validation in a new prospective cohort.

Wingbermühle, Roel W / Chiarotto, Alessandro / van Trijffel, Emiel / Stenneberg, Martijn S / Kan, Ronald / Koes, Bart W / Heymans, Martijn W

Journal of physiotherapy

2023 Volume 69, Issue 2, Page(s) 100–107

Abstract: Question: Can existing post-treatment prognostic models for predicting neck pain recovery (primarily in terms of disability and secondarily in terms of pain intensity and perceived improvement) be externally validated and updated at the end of the ... ...

Abstract	Question: Can existing post-treatment prognostic models for predicting neck pain recovery (primarily in terms of disability and secondarily in terms of pain intensity and perceived improvement) be externally validated and updated at the end of the treatment period and at 6 and 12 weeks of follow-up in a new Dutch cohort of people with neck pain treated with guideline-based usual care physiotherapy? Design: External validation and model updating in a new prospective cohort of three previously developed prognostic models. Participants: People with (sub)acute neck pain and registered for primary care physiotherapy treatment. Outcome measures: Recovery of disability, pain intensity, and perceived recovery at 6 and 12 weeks and at the end of the treatment period. Results: Discriminative performance (c-statistic) of the disability model at 6 weeks was 0.73 (95% CI 0.69 to 0.77) and reasonably well calibrated after intercept recalibration. The disability model at 12 weeks and at the end of the treatment period showed discriminative c-statistic performance values of 0.69 (95% CI 0.64 to 0.73) and 0.68 (95% CI 0.63 to 0.72), respectively, and was well calibrated. Pain models and perceived recovery models did not reach acceptable performance. Cervical mobility added value to the disability models and pain catastrophising to the disability and pain models at 6 weeks. Discussion: Broad external validation of the disability model was successful in people with (sub)acute neck pain and clinicians may use this model in clinical practice with reasonable accuracy. Further research is required to assess the disability model's clinical impact and generalisability, and to identify additional valuable model predictors. Registration: https://osf.io/a6r3k/.
MeSH term(s)	Humans ; Prognosis ; Neck Pain/therapy ; Prospective Studies
Language	English
Publishing date	2023-03-21
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2543915-7
ISSN	1836-9561 ; 1836-9553 ; 0004-9514
ISSN (online)	1836-9561
ISSN	1836-9553 ; 0004-9514
DOI	10.1016/j.jphys.2023.02.002
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Article ; Online: Red flags to screen for vertebral fracture in patients presenting with low-back pain.

Williams, Christopher M / Henschke, Nicholas / Maher, Christopher G / van Tulder, Maurits W / Koes, Bart W / Macaskill, Petra / Irwig, Les

The Cochrane database of systematic reviews

2023 Volume 11, Page(s) CD008643

Abstract: Editorial note: See https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014461.pub2/full for a more recent review that covers this topic and has superseded this review.: Background: Low-back pain (LBP) is a common condition seen in primary ... ...

Abstract	Editorial note: See https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014461.pub2/full for a more recent review that covers this topic and has superseded this review. Background: Low-back pain (LBP) is a common condition seen in primary care. A principal aim during a clinical examination is to identify patients with a higher likelihood of underlying serious pathology, such as vertebral fracture, who may require additional investigation and specific treatment. All 'evidence-based' clinical practice guidelines recommend the use of red flags to screen for serious causes of back pain. However, it remains unclear if the diagnostic accuracy of red flags is sufficient to support this recommendation. Objectives: To assess the diagnostic accuracy of red flags obtained in a clinical history or physical examination to screen for vertebral fracture in patients presenting with LBP. Search methods: Electronic databases were searched for primary studies between the earliest date and 7 March 2012. Forward and backward citation searching of eligible studies was also conducted. Selection criteria: Studies were considered if they compared the results of any aspect of the history or test conducted in the physical examination of patients presenting for LBP or examination of the lumbar spine, with a reference standard (diagnostic imaging). The selection criteria were independently applied by two review authors. Data collection and analysis: Three review authors independently conducted 'Risk of bias' assessment and data extraction. Risk of bias was assessed using the 11-item QUADAS tool. Characteristics of studies, patients, index tests and reference standards were extracted. Where available, raw data were used to calculate sensitivity and specificity with 95% confidence intervals (CI). Due to the heterogeneity of studies and tests, statistical pooling was not appropriate and the analysis for the review was descriptive only. Likelihood ratios for each test were calculated and used as an indication of clinical usefulness. Main results: Eight studies set in primary (four), secondary (one) and tertiary care (accident and emergency = three) were included in the review. Overall, the risk of bias of studies was moderate with high risk of selection and verification bias the predominant flaws. Reporting of index and reference tests was poor. The prevalence of vertebral fracture in accident and emergency settings ranged from 6.5% to 11% and in primary care from 0.7% to 4.5%. There were 29 groups of index tests investigated however, only two featured in more than two studies. Descriptive analyses revealed that three red flags in primary care were potentially useful with meaningful positive likelihood ratios (LR+) but mostly imprecise estimates (significant trauma, older age, corticosteroid use; LR+ point estimate ranging 3.42 to 12.85, 3.69 to 9.39, 3.97 to 48.50 respectively). One red flag in tertiary care appeared informative (contusion/abrasion; LR+ 31.09, 95% CI 18.25 to 52.96). The results of combined tests appeared more informative than individual red flags with LR+ estimates generally greater in magnitude and precision. Authors' conclusions: The available evidence does not support the use of many red flags to specifically screen for vertebral fracture in patients presenting for LBP. Based on evidence from single studies, few individual red flags appear informative as most have poor diagnostic accuracy as indicated by imprecise estimates of likelihood ratios. When combinations of red flags were used the performance appeared to improve. From the limited evidence, the findings give rise to a weak recommendation that a combination of a small subset of red flags may be useful to screen for vertebral fracture. It should also be noted that many red flags have high false positive rates; and if acted upon uncritically there would be consequences for the cost of management and outcomes of patients with LBP. Further research should focus on appropriate sets of red flags and adequate reporting of both index and reference tests.
MeSH term(s)	Humans ; Spinal Fractures/complications ; Spinal Fractures/diagnosis ; Low Back Pain/diagnosis ; Low Back Pain/etiology ; Physical Examination ; Sensitivity and Specificity
Language	English
Publishing date	2023-11-28
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ISSN	1469-493X
ISSN (online)	1469-493X
DOI	10.1002/14651858.CD008643.pub3
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