THE CENTRALIZATION PHENOMENON - ITS USEFULNESS AS A PREDICTOR OF OUTCOME IN CONSERVATIVE TREATMENT OF CHRONIC LOW-BACK-PAIN (A PILOT-STUDY)

Study Design. Two-hundred-forty-three patients with chronic low back p ain were studied in a prospective comparative survey to determine whet her the ''centralization phenomenon'' was associated with outcome afte r an interdisciplinary work-hardening program. Objective. The hypothes is was that patients who demonstrated centralization during initial me chanical assessment would have better outcomes than noncentralizers. S ummary of Background Data. Overall, subjects has decreased pain intens ity ratings (mean 10%), increased lifting ability (6-8 kg), and a 59.2 % return-to-work rate at a mean of 9.7 months follow-up. Methods. Pati ents were classified as either centralizers or noncentralizers, based on results of their initial assessment. Changes in pain rating, one-ti me maximal weights lifted, Oswestry scores, and return-to-work status were compared between groups. Results. The centralizers reported signi ficant decreased in their maximum pain rating (centralizers, 16%; nonc entralizers, 6%) and had a higher reutrn-to-work rate (centralizers, 6 8%; noncentralizers, 52%) than the noncentralizers. Conclusion. Centra lization can help identify sub-groups within the population with chron ic low back pain and could be a useful goal setting and case managemen t tool in the rehabilitation of low back pain.