@article{WippertArampatzisBanzeretal.2019, author = {Wippert, Pia-Maria and Arampatzis, Adamantios and Banzer, Winfried and Beck, Heidrun and Hasenbring, Monika Ilona and Schiltenwolf, Marcus and Schneider, Christian and Stengel, Dirk and Platen, Petra and Mayer, Frank}, title = {Psychosoziale Risikofaktoren in der Entstehung von chronisch unspezifischen R{\"u}ckenschmerzen}, series = {Zeitschrift f{\"u}r Sportpsychologie}, volume = {26}, journal = {Zeitschrift f{\"u}r Sportpsychologie}, number = {1}, publisher = {Hogrefe}, address = {G{\"o}ttingen}, issn = {1612-5010}, doi = {10.1026/1612-5010/a000245}, pages = {25 -- 35}, year = {2019}, abstract = {Chronisch unspezifische R{\"u}ckenschmerzen (CURS) geh{\"o}ren international zu den h{\"a}ufigsten Schmerzph{\"a}nomenen und k{\"o}nnen f{\"u}r Athletinnen und Athleten karrierelimitierend sein. Knapp ein Drittel der j{\"a}hrlichen Trainingsausfallzeiten werden auf CURS zur{\"u}ckgef{\"u}hrt. In der Entstehung von chronischen Schmerzen ist ein multifaktorielles {\"A}tiologiemodell mit einem signifikanten Einfluss psychosozialer Risikofaktoren evident. Obwohl dies in der Allgemeinbev{\"o}lkerung bereits gut erforscht ist, gibt es in der Sportwissenschaft vergleichsweise wenige Arbeiten dar{\"u}ber. Dieses Thema wird daher in drei Multicenterstudien und zahlreichen Teilstudien des MiSpEx-Netzwerks (Medicine in Spine-Exercise-Network, F{\"o}rderzeitraum 2011 - 2018) aufgegriffen. Entsprechend der Empfehlung einer fr{\"u}hzeitigen Diagnostik von Chronifizierungsfaktoren in der „Nationalen Versorgungsleitlinie Kreuzschmerz", besch{\"a}ftigt sich das Netzwerk u. a. mit der {\"U}berpr{\"u}fung, Entwicklung und Evaluation diagnostischer M{\"o}glichkeiten. Der vorliegende Beitrag beschreibt die Entwicklung einer Diagnostik von psychosozialen Risikofaktoren, die einerseits eine Einsch{\"a}tzung des Risikos der Entwicklung von CURS und andererseits eine individuelle Zuweisung zu (Trainings)Interventionen erlaubt. Es wird die Entwicklungsrationale beschrieben und dabei verschiedene methodische Herangehensweisen und Entscheidungssequenzen reflektiert.}, language = {de} } @misc{WippertPuschmannDriessleinetal.2017, author = {Wippert, Pia-Maria and Puschmann, Anne-Katrin and Drießlein, David and Arampatzis, Adamantios and Banzer, Winfried and Beck, Heidrun and Schiltenwolf, Marcus and Schmidt, Hendrik and Schneider, Christian and Mayer, Frank}, title = {Development of a risk stratification and prevention index for stratified care in chronic low back pain. Focus: yellow flags (MiSpEx network)}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-403424}, pages = {11}, year = {2017}, abstract = {Introduction: Chronic low back pain (LBP) is a major cause of disability; early diagnosis and stratification of care remain challenges. Objectives: This article describes the development of a screening tool for the 1-year prognosis of patients with high chronic LBP risk (risk stratification index) and for treatment allocation according to treatment-modifiable yellow flag indicators (risk prevention indices, RPI-S). Methods: Screening tools were derived from a multicentre longitudinal study (n = 1071, age >18, intermittent LBP). The greatest prognostic predictors of 4 flag domains ("pain," "distress," "social-environment," "medical care-environment") were determined using least absolute shrinkage and selection operator regression analysis. Internal validity and prognosis error were evaluated after 1-year follow-up. Receiver operating characteristic curves for discrimination (area under the curve) and cutoff values were determined. Results: The risk stratification index identified persons with increased risk of chronic LBP and accurately estimated expected pain intensity and disability on the Pain Grade Questionnaire (0-100 points) up to 1 year later with an average prognosis error of 15 points. In addition, 3-risk classes were discerned with an accuracy of area under the curve = 0.74 (95\% confidence interval 0.63-0.85). The RPI-S also distinguished persons with potentially modifiable prognostic indicators from 4 flag domains and stratified allocation to biopsychosocial treatments accordingly. Conclusion: The screening tools, developed in compliance with the PROGRESS and TRIPOD statements, revealed good validation and prognostic strength. These tools improve on existing screening tools because of their utility for secondary preventions, incorporation of exercise effect modifiers, exact pain estimations, and personalized allocation to multimodal treatments.}, language = {en} } @article{WippertPuschmannDriessleinetal.2017, author = {Wippert, Pia-Maria and Puschmann, Anne-Katrin and Drießlein, David and Arampatzis, Adamantios and Banzer, Winfried and Beck, Heidrun and Schiltenwolf, Marcus and Schmidt, Hendrik and Schneider, Christian and Mayer, Frank}, title = {Development of a risk stratification and prevention index for stratified care in chronic low back pain. Focus: yellow flags (MiSpEx network)}, series = {Pain reports}, volume = {9}, journal = {Pain reports}, publisher = {Wolters Kluwer Health}, address = {Riverwoods, IL}, doi = {10.1097/PR9.0000000000000623}, pages = {1 -- 11}, year = {2017}, abstract = {Introduction: Chronic low back pain (LBP) is a major cause of disability; early diagnosis and stratification of care remain challenges. Objectives: This article describes the development of a screening tool for the 1-year prognosis of patients with high chronic LBP risk (risk stratification index) and for treatment allocation according to treatment-modifiable yellow flag indicators (risk prevention indices, RPI-S). Methods: Screening tools were derived from a multicentre longitudinal study (n = 1071, age >18, intermittent LBP). The greatest prognostic predictors of 4 flag domains ("pain," "distress," "social-environment," "medical care-environment") were determined using least absolute shrinkage and selection operator regression analysis. Internal validity and prognosis error were evaluated after 1-year follow-up. Receiver operating characteristic curves for discrimination (area under the curve) and cutoff values were determined. Results: The risk stratification index identified persons with increased risk of chronic LBP and accurately estimated expected pain intensity and disability on the Pain Grade Questionnaire (0-100 points) up to 1 year later with an average prognosis error of 15 points. In addition, 3-risk classes were discerned with an accuracy of area under the curve = 0.74 (95\% confidence interval 0.63-0.85). The RPI-S also distinguished persons with potentially modifiable prognostic indicators from 4 flag domains and stratified allocation to biopsychosocial treatments accordingly. Conclusion: The screening tools, developed in compliance with the PROGRESS and TRIPOD statements, revealed good validation and prognostic strength. These tools improve on existing screening tools because of their utility for secondary preventions, incorporation of exercise effect modifiers, exact pain estimations, and personalized allocation to multimodal treatments.}, language = {en} }