An exploration of Maitland's concept of pain irritability in patients with low back pain

Edward T. Barakatt, Patrick S Romano, Daniel L. Riddle, Laurel A Beckett, Richard L Kravitz

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Maitland's construct of musculoskeletal pain irritability is widely used by physical therapists for making decisions about the vigor of examination and treatment, but this construct has not been defined to the extent that its measurement properties can be tested. The purposes of this study were to 1) determine if physical therapists utilize low back pain (LBP) irritability judgments to make treatment decisions, 2) identify LBP characteristics appropriate for an LBP irritability construct, and 3) develop a measurement construct of LBP irritability. Physical therapists evaluated and treated 183 subjects with LBP. The therapists judged the subjects' LBP as irritable or non-irritable, and recorded treatments provided at the initial visit. A principal-components analysis (PCA) was performed on 14 patient-reported LBP characteristics to identify potential components of a measurement construct of LBP irritability. The therapists' irritability judgments were found to be associated with the types of treatments prescribed. Five dimensions of LBP irritability were identified by the PCA from the 14 LBP characteristics considered. Four of these dimensions were associated with the therapists' LBP irritability judgments. The Roland-Morris Disability Questionnaire, presence of distal symptoms, and forward bending tolerance were found to have a stronger association with the irritability judgments than the dimensions of irritability identified in this study. Validated measures of LBP characteristics in current clinical use may adequately capture Maitland's concept of irritability.

Original languageEnglish (US)
Pages (from-to)196-205
Number of pages10
JournalJournal of Manual and Manipulative Therapy
Volume17
Issue number4
StatePublished - 2009

Fingerprint

Low Back Pain
Pain
Physical Therapists
Principal Component Analysis
Musculoskeletal Pain
Therapeutics
Decision Making

Keywords

  • Evaluation
  • Low back pain
  • Low back pain irritability
  • Lumbar spine
  • Maitland

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

An exploration of Maitland's concept of pain irritability in patients with low back pain. / Barakatt, Edward T.; Romano, Patrick S; Riddle, Daniel L.; Beckett, Laurel A; Kravitz, Richard L.

In: Journal of Manual and Manipulative Therapy, Vol. 17, No. 4, 2009, p. 196-205.

Research output: Contribution to journalArticle

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