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  • Chronic Low Back Pain Research Standards Proposed

    Citing a lack of consistency in investigations into one of the most widespread chronic conditions in the world, last month the National Institutes of Health (NIH) released a task force report that seeks to establish standards for research into chronic low back pain (cLBP). The new standards are being recommended to be included as requirements of future NIH grant proposals.

    The NIH Task Force on Research Standards for Chronic Low Back Pain, which includes Anthony DeLitto PT, PhD, FAPTA, issued a June 20 report that featured recommendations around how cLBP is defined, categorized, measured, and reported. The aim, according to the report's authors, is to change the current state of research on cLBP, which they say makes it "difficult to compare epidemiologic data and studies of similar or competing interventions, replicate findings, pool data from multiple sources, resolve conflicting conclusions, develop multidisciplinary consensus, or even achieve consensus within a discipline regarding interpretation of findings."

    The recommendations of the task force include:

    • Definition of cLBP as "a back pain problem that has persisted at least 3 months and has resulted in pain on at least half the days in the past 6 months."
    • Stratification of cLBP impact by "personal impact" considerations including pain intensity, pain interference with normal activities, and functional status.
    • Establishment of a minimum data set for describing individuals participating in all research studies on cLBP that captures demographics, medical history, and self-report of symptoms and function including pain intensity, physical interference, depression, and sleep disturbance.
    • Affirmation of earlier consensus documents on outcome measures for chronic pain.

    The task force recommends the Patient Reported Outcomes Measurement Information System (PROMIS) as a good instrument for self-report measures, but adds that other well-validated measures are acceptable.

    "Any effort to standardize research methods is only a starting point for further testing and refinement," the authors state. "The final recommendations were seen as a first step toward creating standards for research in cLBP. We anticipate that further validation, refinement, and possible extension of these recommendations will require years and the efforts of many investigators."

    APTA has a long history of involvement in the development of information and resources on back pain. Some of the resources available to physical therapists include a MoveForwardPT.com webpage on low back pain, clinical practice guidelines on low back pain (.pdf), and an APTA Learning Center presentation on manipulation for low back pain. PTNow provides full-text access to the latest clinical practice guidelines and Cochrane systematic reviews related to low back pain and neck pain.

    Brain-Powered Movement Achieved in Patient With Paralysis

    Researchers at The Ohio State University have successfully engineered an electronic neural bypass system that has allowed an individual who is quadriplegic to move his hand and fingers with his thoughts alone.

    The system, dubbed Neurobridge, connects a microchip implanted on the motor cortex of a patient's brain to a computer, which uses algorithms to learn and interpret the patient's brain signals and send them on to a sleeve that stimulates the muscles required to perform a certain movement. Total time from thought to movement is reported to be less than a tenth of a second.

    The system debuted recently when Ian Burkhart, a 23-year-old man who was paralyzed in a swimming accident, clenched and unclenched his fingers, rotated his wrist, and picked up a spoon. Stories and videos on the trial have appeared in The Washington Post, ABC News, and Computerworld, among other media outlets.