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Objective Despite rapidly increasing intervention, functional disability due to chronic low back pain ( cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed non-specific, and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. Design Expert panel and preliminary evaluation of key recommendations. Methods The NIH Pain Consortium charged a Research Task Force ( RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel developed a 3-stage process, each with a 2-day meeting. Results The panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimal data set to describe research subjects (drawing heavily on the PROMIS methodology); reporting 'responder analyses' in addition to mean outcome scores; and suggestions for future research and dissemination. The Pain Consortium has approved the recommendations, which investigators should incorporate into NIH grant proposals. Conclusion The RTF believes these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of chronic low back pain. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes. We expect the RTF recommendations will become a dynamic document, and undergo continual improvement. Perspective A task force was convened by the NIH Pain Consortium with the goal of developing research standards for chronic low back pain. The results included recommendations for definitions, a minimum dataset, reporting outcomes, and future research. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes. [ABSTRACT FROM AUTHOR]

Background Context: Rehabilitation services using intensive exercise for the treatment of chronic spinal pain have traditionally been scheduled at a frequency of three times per week.Purpose: In an attempt to reduce the cost of rehabilitation services, this study was designed to determine whether treatment offered two times per week could produce similar outcomes when compared with an established three times per week spine therapy program.Study Design: Prospective cohort study.Patient Sample: Seventy-seven consecutive patients with chronic spinal pain were treated with aggressive spine rehabilitation either two or three times per week.Outcome Measures: Flexibility, trunk strength and lifting capacity were quantified before and after treatment. Pain visual analog scores and Oswestry disability scores were measured before and after treatment, as well as 12 months after treatment.Methods: A two times per week physical therapy program was developed to be identical in its treatment method to an established three times per week, group-oriented physical therapy program used for the treatment of chronic spinal pain. Patients with spinal pain who continued to work despite chronic pain complaints were allowed to choose between the two therapy programs based on availability of treatment slots and convenience. Treatment consisted of non-pain contingent quota-based exercises targeting identified physical impairments. Treatment sessions lasted for 2 hours and consisted of 30 minutes of stretching, 30 minutes of low-impact step aerobics class and 1 hour of exercise on strength and endurance equipment. Therapy occurred in groups consisting of a maximum of eight patients who were closely supervised by two therapists. Targeted treatment time was 6 weeks. At 12 months after treatment, subjects were surveyed by mailed questionnaires.Results: Seventy-seven patients with chronic spinal pain with a mean duration of symptoms of 32 months underwent treatment. Twenty-four subjects opted for the twice per week and 53 opted for the three times per week treatment. Seventy-one percent of subjects responded to the 12-month follow-up questionnaire. Physical and self-reported measures improved with both treatment frequencies. There were no differences in outcomes between treatment frequencies for measured flexibility, trunk strength, lifting capacity, pain intensity scores or Oswestry scores at the completion of treatment. At 12-month follow-up, no differences were noted between treatment frequencies for pain scores, Oswestry scores, patients' perceptions of adequacy of treatment, posttreatment exercise compliance or use of other treatments for their spinal problem. Total therapy visits were less in the two than three times per week groups (12 vs 15 visits).Conclusion: Similar outcomes were obtained from aggressive spine rehabilitation occurring two versus three times per week in patients presenting with moderate levels of chronic spinal pain. Reduction in physical therapy services and therefore cost did not adversely affect clinical outcomes in the treatment of this patient population. [ABSTRACT FROM AUTHOR]

The article reports that the National Institute of Health (NIH) Pain Consortium convened a task force with the aim of developing research standards for chronic low back pain. The results included recommendations for definitions, minimum dataset and reporting outcomes which the Research Task Force believes will become a dynamic document and undergo continuous improvement.