Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748, USA.
Spine (Phila Pa 1976). 2011 Sep 1;36(19):1608-14. doi: 10.1097/BRS.0b013e3181f6114e.
Synthesis and analysis of presentation and discussion highlights, with a focus on emerging trends and promising new directions in primary care research on low back pain (LBP).
To present a summary of findings, themes, and insights from the Tenth International Forum on Primary Care Research on Low Back Pain, a meeting of researchers designed to share the latest concepts, methods, and results of research on LBP diagnosis, treatment, and disability prevention.
Earlier Forum meetings have developed several common themes and general conclusions. These are contrasted with the presentations and discussions at the 10th International Forum.
Major themes included concerns about the epidemic of chronic, disabling LBP, associated treatments, iatrogenesis, and the "LBP medical industrial complex"; the variability and complexity of outcomes and how their importance differed across patients in defining recovery and recurrence; the power of nonspecific effects, expectations, and therapeutic alliance; and the challenges of identifying important therapeutic subgroups. New research addressed early risk factor screening and linked intervention, nonmedical approaches to reframe the LBP problem and avoid unnecessary care, cognitive and behavioral aspects of LBP, and ways to train clinicians to implement these innovations. More appropriate use of longitudinal designs and a greater focus on implementation research was called for.
Although the field of primary care LBP research often seems to progress slowly, the Forum highlighted several important, promising developments that could substantially improve LBP research and primary care practice.
重点关注初级保健领域中针对下背痛（LBP）的研究的新兴趋势和有前途的新方向，对演讲和讨论要点进行综合分析和研究。
总结第十届国际初级保健研究论坛关于下背痛的研究成果、主题和观点，这是一次旨在分享 LBP 诊断、治疗和残疾预防研究的最新概念、方法和结果的研究人员会议。
早期的论坛会议已经形成了几个共同的主题和总体结论。这些与第十届国际论坛的演讲和讨论形成对比。
主要主题包括对慢性、致残性 LBP 的流行、相关治疗、医源性和“LBP 医疗产业综合体”的担忧；结果的可变性和复杂性，以及它们在定义康复和复发方面对不同患者的重要性差异；非特异性效应、期望和治疗联盟的力量；以及确定重要治疗亚组的挑战。新的研究涉及早期风险因素筛查和干预、重新定义下背痛问题并避免不必要的护理的非医疗方法、下背痛的认知和行为方面，以及培训临床医生实施这些创新的方法。需要更合理地使用纵向设计，并更加关注实施研究。
尽管初级保健 LBP 研究领域的进展似乎常常缓慢，但论坛强调了一些重要的、有前途的发展，这些发展可能会极大地改善 LBP 研究和初级保健实践。
