Table 4 Adherence to select behaviors from the Best Practices List (6 of 38 behaviors with ≥14 applicable charts pre- and post-PEAK)

Outcome Measurement

The modified Oswestry Disability Index should be administered at the beginning and end of treatment [33, 36, 37].

7.7 % (5/65)

12.5 % (3/24)

0.482

Fear Avoidance Beliefs Questionnaire administered at the beginning and end of treatment [37].

6.2 % (4/65)

4.2 % (1/24)

0.718

A depression screen should be conducted with the following two questions (1) “During the past month, have you often been bothered by feeling down, depressed, or hopeless?” and (2) “During the past month, have you often been bothered by little interest or pleasure in doing things?” [38].

55.4 % (36/65)

95.8 % (23/24)

<0.001

Non-specific Low Back Pain

Patients with non-specific LBP should be assessed for lumbar instability based on the following criteria: (1) positive prone instability test; (2) positive (>6/9) Beighton scale; (3) aberrant movement patterns (instability catch, Gower sign); (4) production of pain with mobilization of hypermobile segment (especially L4-5, and L5-L1); and/or (5) presence of excessive lumbar mobility (excessive lumbar flexion/reversal of lumbar lordosis) [37, 39, 40].

44.1 % (26/59)

33.3 % (6/18)

0.151

For patients with chronic (>12 weeks) LBP, a progressive exercise program (neuromuscular control, strength, and endurance) should be provided. If a patient meets this criterion but is not provided with progressive exercises, the reason should be documented [41].

92.7 % (38/41)

87.5 % (14/16)

0.563

For patients with chronic (>12 weeks duration) non-specific LBP, a multidisciplinary rehabilitation program (including exercise, psychological pain management, back school, PT/OT, psychology/psychiatry, and medical management) should be considered. Therapists should document discussion of the appropriateness of such an intensive program with patients with chronic non-specific LBP [42].

9.8 % (4/41)

12.5 % (2/16)

0.297