Journal article

A Definition of "Flare" in Low Back Pain: A Multiphase Process Involving Perspectives of Individuals With Low Back Pain and Expert Consensus.

  • Costa N The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.
  • Ferreira ML The University of Sydney, Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, Sydney, Australia.
  • Setchell J The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.
  • Makovey J The University of Sydney, Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, Sydney, Australia.
  • Dekroo T The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.
  • Downie A Musculoskeletal Health Sydney, University of Sydney, Sydney, Australia; Department of Chiropractic, Macquarie University, Sydney, Australia.
  • Diwan A Spine Service, Department of Orthopaedic Surgery, St. George & Sutherland Clinical School, University of New South Wales Australia, Kogarah, Sydney, Australia.
  • Koes B Department of General Practice, Erasmus MC, Rotterdam, the Netherlands; Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark.
  • Natvig B Institute for Health and Society, Department of General Practice, University of Oslo, Oslo, Norway.
  • Vicenzino B The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.
  • Hunter D The University of Sydney, Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, Sydney, Australia; Department of Rheumatology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
  • Roseen EJ Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts.
  • Rasmussen-Barr E Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Stockholm, Sweden.
  • Guillemin F Universite de Lorraine, CHRU Nancy, Inserm, CIC1433-Epidemiologie Clinique, Nancy, France.
  • Hartvigsen J Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark.
  • Bennell K Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Melbourne, The University of Melbourne, Victoria, Australia.
  • Costa L Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.
  • Macedo L McMaster University School of Rehabilitation Science Hamilton, Ontario, Canada.
  • Pinheiro M Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
  • Underwood M Warwick Medical School, University of Warwick, Coventry, United Kingdom.
  • Van Tulder M Department of Health Sciences, Faculty of Science, Vrije Universiteit, Amsterdam Movement Science research institute, Amsterdam, the Netherlands.
  • Johansson M Warwick Medical School, University of Warwick, Coventry, United Kingdom; Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark.
  • Enthoven P Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
  • Kent P Department of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
  • O'Sullivan P Department of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
  • Suri P Seattle Epidemiologic Research and Information Center (ERIC) and Division of Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, Washington; Department of Rehabilitation Medicine, University of Washington, Seattle, Washington; New England Baptist Hospital, Boston, Massachusetts; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.
  • Genevay S Division of Rheumatology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland.
  • Hodges PW The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia. Electronic address: p.hodges@uq.edu.au.
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  • 2019-03-25
Published in:
  • The journal of pain : official journal of the American Pain Society. - 2019
English Low back pain (LBP) varies over time. Consumers, clinicians, and researchers use various terms to describe LBP fluctuations, such as episodes, recurrences and flares. Although "flare" is use commonly, there is no consensus on how it is defined. This study aimed to obtain consensus for a LBP flare definition using a mixed-method approach. Step 1 involved the derivation of a preliminary candidate flare definition based on thematic analysis of views of 130 consumers in consultation with an expert consumer writer. In step 2, a workshop was conducted to incorporate perspectives of 19 LBP experts into the preliminary flare definition, which resulted in 2 alternative LBP flare definitions. Step 3 refined the definition using a 2-round Delphi consensus with 50 experts in musculoskeletal conditions. The definition favored by experts was further tested with 16 individuals with LBP in step 4, using the definition in three scenarios. This multiphase study produced a definition of LBP flare that distinguishes it from other LBP fluctuations, represents consumers' views, involves expert consensus, and is understandable by consumers in clinical and research contexts: "A flare-up is a worsening of your condition that lasts from hours to weeks that is difficult to tolerate and generally impacts your usual activities and/or emotions." Perspective: A multiphase process, incorporating consumers' views and expert consensus, produced a definition of LBP flare that distinguishes it from other LBP fluctuations.
Language
  • English
Open access status
green
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Persistent URL
https://folia.unifr.ch/global/documents/194370
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