Off-campus Pacific University users: To download campus access theses and dissertations, please log into our proxy server with your PUNet ID and password.

Non-Pacific University users: Please talk to your librarian about requesting this thesis or dissertation through interlibrary loan.

Theses or dissertations that have a specific embargo period indicated below will not be available to anyone until the date indicated.

Date of Award

5-2007

Degree Type

Capstone Project (On-Campus Access Only)

Degree Name

Doctor of Physical Therapy (DPT)

First Advisor

John Medeiros, PhD, PT

Abstract

1. Clinical Bottom Line: Waddell’s signs and symptoms are not effective for predicting delay or non-return to work in patients with work restricting low back pain.

2. Clinical Scenario: In the outpatient orthopedic setting, clinicians play a large role in the treatment of patients with work-restricting low back pain. A majority of these patients experience chronic low back pain, enabling them from return to work in a timely fashion and increasing health care costs and compensation benefits dispersed. As a clinician, you hope to utilize specific tools that will validly predict the outcome of physical therapy treatment; and more specifically in this case, return to work. While working with a veteran clinician, we observed the use of Waddell signs as a predictive tool for patients with chronic work-restricting low back pain. A majority of the patients were taking part in a work hardening program where a clinical psychologist was available for consultation and intervention. Many others, not a part of the work hardening program, were receiving compensation benefits. There was a wide range of patients seen by this clinician, but every initial evaluation included a screening for Waddell signs. However, the use of these signs as a predictive tool for non-return to work is not a topic discussed readily amongst health professionals, and within the physical therapy school curriculum. Thus, to determine the validity and efficacy of these signs we established the following clinical question: Are Waddell Signs an effective predictive test for delayed or non-return to work in patients with low back pain?

3. Our Clinically Answerable Question: Population: Patients with low back pain, unable to perform full time work duties. Independent Variable: Physical examination for the presence of Waddell signs. Comparison: Return to full time work. Outcome Measure(s): Efficacy of Waddell signs measured by sensitivity, specificity, predictive values, and likelihood ratios.

Comments

The digital version of this project is currently unavailable to off-campus users not affiliated with Pacific University; however, it may be accessed on campus or through interlibrary loan (for eligible borrowers) from Pacific University Library. Pacific University Library is a free lender.

Share

COinS