WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS427–eS632 for eight weeks. Oxidative stress and antioxidant activity were measured by Free Radical Analytical System 4. Statistical analysis was performed by IBM SPSS Statistics 21.0 and Scheffe’s test was used for multiple comparison among the three groups with statistical significance of P < 0.05. Results: When these animals grew to adulthood eight weeks after starting the experiment, oxidative stress at rest was significantly high only in Group J by 28.2% relative to Group C (P < 0.05). Oxidative stress at rest significantly increased in all groups at eight weeks compared to the preexperimental state (all P < 0.001). A comparison of pre- and post-experimental antioxidant activity in all groups showed a significant decrease in Groups C and T at eight weeks (all P < 0.001). Conclusion(s): An increase in oxidative stress can surpass anti-oxidative stress activity depending on the intensity, duration, and types of exercise. Our study also implied that oxidative stress may increase with musculoskeletal growth in adulthood. Particularly for exercise in the growth stage, it was suggested that active oxygen produced by muscle damage through anaerobic exercise such as jumping had a greater effect on oxidative stress than that by aerobic exercise. It was also indicated that antioxidant activity constantly changes to control oxidative stress within a certain level in response to an increase in oxidative stress. Implications: Our study suggested that anaerobic exercise in the growth stage can help enhance antioxidant activity. However, exercise itself can possibly inflict serious damage on the living body. Therefore, exercise in the growth stage should be demonstrated with good consideration of exercise modality and load. These results are helpful as preclinical data for pediatric physiotherapy. Keywords: Growth stage; Oxidative stress; Antioxidant activity Funding acknowledgements: This research was done by the research cost of Aomori University of Health and Welfare. Ethics approval: This research obtained and carried out consent of the Ethics Committee of Aomori University of Health and Welfare. http://dx.doi.org/10.1016/j.physio.2015.03.3354 eS543 Research Report Platform Presentation Number: RR-PL-1230 Sunday 3 May 2015 11:07 Rooms 328–329 A SYSTEMATIC REVIEW OF DIAGNOSTIC CLINICAL PREDICTION RULES FOR LOW BACK PAIN R. Haskins, P.G. Osmotherly, D.A. Rivett The University of Newcastle, School of Health Sciences, Newcastle, Australia Background: The identification of subgroups of patients with low back pain (LBP) is a priority research area. Significant resources have been invested in the development of clinical prediction rules (CPRs) that function to identify subgroups of patients with LBP who meaningfully differ in regard to their symptomology, prognosis and response to various treatments. Previous reviews on this subject have predominantly focused on tools designed to predict future patient outcomes and treatment effects. Presently, very little is known about diagnostic forms of CPRs for LBP that seek to inform decisions regarding a patient’s present status or classification. It is not yet known whether such tools have been sufficiently developed to enable their clinical application at this time. Purpose: The purpose of this study was to identify diagnostic forms of CPRs for LBP and to investigate their readiness for clinical application. Methods: A systematic literature review was conducted using a sensitive electronic search strategy across 7 databases. Hand-searching and citation tracking were used as supplementary search strategies. Identified records were screened for eligibility by two independent reviewers by title and abstract. The full-text of potentially eligible studies were subsequently evaluated by both reviewers with concordance determining study eligibility. Disagreements were resolved by consensus or by a third reviewer if needed. The methodological quality of included studies was evaluated by two reviewers using QUADAS-2 and also against a checklist of accepted methodological standards for CPR development studies. Results: 10,014 records were screened for eligibility with 15 publications included in this review. Thirteen diagnostic CPRs for LBP were identified to have been derived. A CPR that assists in the identification of lumbar spinal stenosis and two rules that assist in the identification of inflammatory back pain (‘Berlin criteria’ and ‘IBP according to experts’) have undergone validation. No studies were identified that sought to investigate the impact resulting from the clinical application of such tools. Conclusion(s): Most diagnostic CPRs for LBP are presently in their initial stage of development. The ability eS544 WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS427–eS632 of diagnostic CPRs for LBP to beneficially impact clinical practice has not yet been investigated. Implications: Diagnostic forms of CPRs for LBP have not yet been developed sufficiently to enable clinicians to apply them in practice with confidence that their use will likely result in improved patient management. There is a need to progress the development of the derived CPRs identified in this review. Further validation and impact analysis of a 10-item CPR that functions to assist in the identification of patients with probable lumbar spinal stenosis is indicated. Validation of the ‘Berlin criteria’ and ‘IBP according to experts’ CPRs in primary care settings is also warranted. Keywords: Low back pain; Clinical prediction rule; Diagnosis Funding acknowledgements: No funding was received in relation to this study. Ethics approval: Ethics approval was not required for this study. http://dx.doi.org/10.1016/j.physio.2015.03.3355 Research Report Poster Presentation Number: RR-PO-10-02-Sun Sunday 3 May 2015 13:00 Exhibit halls 401–403 PROGNOSTIC AND PRESCRIPTIVE CLINICAL PREDICTION RULES FOR LOW BACK PAIN: A SYSTEMATIC REVIEW R. Haskins, P.G. Osmotherly, D.A. Rivett The University of Newcastle, School of Health Sciences, Newcastle, Australia Background: Populations of patients with low back pain (LBP) are generally considered to be comprised of smaller subgroups who differ in regard to their prognosis and relative response to given interventions. Identifying these subgroups and targeting interventions provides individual and population level benefits. Clinical prediction rules (CPRs) are tools that function to facilitate such stratification of care and have been developed in increasing numbers for LBP in recent years. Previous reviews on this topic have limited their scope to CPRs developed for specific interventions, a particular health profession or to a particular stage of CPR development. Consequently, it is probable that many relevant prognostic and prescriptive CPRs for LBP have not yet been identified in previous reviews and their readiness for clinical application at this time remains undetermined. Purpose: The purpose of this review was to identify prognostic and prescriptive CPRs relevant to the non-surgical management of LBP, and to assess their readiness for clinical application. Methods: A systematic review of studies reporting on the derivation, validation or impact analysis of prognostic or prescriptive CPRs relevant to the non-surgical management of LBP was conducted. A sensitive electronic search strategy across 7 databases was employed in addition to handsearching and citation tracking. Following the removal of duplicates, two independent reviewers screened the titles and abstracts of identified records for eligibility. Potentially eligible studies were reviewed by full-text by both reviewers with concordance determining whether a study was included or excluded. Disagreements were resolved by consensus or if needed, by a third reviewer. The quality appraisal of included studies was conducted by two reviewers using tools relevant to each study’s specific research design (QUIPS or PEDro scale), and against methodological standards for CPR development studies. Results: 10,005 unique records were screened for eligibility with 35 subsequently included. These studies report on the development of 30 prognostic/prescriptive CPRs for LBP with most (n = 20) derived using patients receiving a specific treatment program. Three CPRs were identified to have undergone validation in one or more studies – the ‘Cassandra rule’ for predicting which patients with LBP are more likely to develop significant functional restrictions, and the 5-item and 2-item Flynn manipulation CPRs that function to predict which patients being treated with lumbopelvic manipulation are likely to experience a favorable prognosis. No impact analysis studies were identified in this review. Conclusion(s): Most of the CPRs identified in this review are in their initial stage of development. The evidence considered in this review provides emergent confidence in the limited predictive performance of the ‘Cassandra rule’ and the 5-item Flynn manipulation CPR in similar patient populations and comparable clinical settings. Neither tool however has been evaluated for its ability to beneficially impact clinical practice. Implications: The majority of prognostic/prescriptive CPRs for LBP require further development before they can confidently be applied in clinical practice. The ‘Cassandra rule’ and the 5-item Flynn manipulation CPR may be applied in specific clinical circumstances with some confidence regarding their known predictive performance. Keywords: Low back pain; Clinical prediction rule; Prognosis Funding acknowledgements: No funding was received in relation to this study. Ethics approval: Ethics approval was not required for this study. http://dx.doi.org/10.1016/j.physio.2015.03.3356