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A definition of flare in low back pain (LBP): A multiphase process involving perspectives of individuals with LBP and expert consensus [Epub ahead of print]

Tidsskriftartikel - 2019

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Low back pain (LBP) varies over time. Consumers, clinicians and researchers use various terms to describe fluctuations of LBP symptoms. Although "flare" is commonly used to describe symptom fluctuation, 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 derivation of a preliminary candidate flare definition based on thematic analysis of consumers' views in consultation with an expert consumer writer. In Step 2, a workshop was conducted to incorporate perspectives of LBP experts into the preliminary flare definition, which resulted in two alternative LBP flare definitions. Step 3 refined the definition using a two-round Delphi consensus process with experts in musculoskeletal conditions. The definition favoured by experts was further tested with individuals with LBP in Step 4, using the definition in three scenarios. This multiphase study produced a LBP flare definition that distinguishes it from other LBP fluctuations, represents views of consumers, 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 processes produced a low back pain (LBP) flare definition that distinguishes it from other LBP fluctuations, involves expert consensus and represents consumers' views.

Reference

Costa N, Ferreira ML, Setchell J, Makovey J, Dekroo T, Downie A, Diwan A, Koes B, Natvig B, Vicenzino B, Hunter D, Roseen E, Rasmussen-Barr E, Guillemin F, Hartvigsen J, Bennell K, Costa L, Macedo L, Pinheiro M, Underwood M, Van Tulder M, Johansson MS, Enthoven P, Kent P, O'Sullivan P, Suri P, Genevay S, Hodges PW. A definition of flare in low back pain (LBP): A multiphase process involving perspectives of individuals with LBP and expert consensus [Epub ahead of print]. Journal of Pain 2019.
doi: 10.1016/j.jpain.2019.03.009

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