Predictors of low back disability in chiropractic and physical therapy settings.
Chiropractic
Chronic non-specific LBP
Physical therapy
Predictors
Prognosis
Journal
Chiropractic & manual therapies
ISSN: 2045-709X
Titre abrégé: Chiropr Man Therap
Pays: England
ID NLM: 101551481
Informations de publication
Date de publication:
12 08 2020
12 08 2020
Historique:
received:
04
03
2020
accepted:
09
06
2020
entrez:
13
8
2020
pubmed:
13
8
2020
medline:
13
1
2021
Statut:
epublish
Résumé
Predicting ongoing disability for chronic non-specific low back pain (LBP) is important to avoid prolonged disability. Determine predictors of disability at 6 month follow-up in patients with LBP at medium risk of ongoing disability. Baseline data was collected from 108 patients with medium-risk chronic non-specific LBP (mean age 50.4 years, SD 13.6) from six private chiropractic and physiotherapy clinics in Australia who took part in a randomised control trial. All patients received a pragmatic course of multimodal physical treatments [e.g., manual therapy (spinal manipulation or mobilization and/or soft tissue massage)] combined with advice, education and exercise. Baseline prognostic variables included sociodemographic, physical and psychological characteristics. Primary outcome was disability (Roland Morris Disability) at 6 month follow-up. Multivariable linear regression analysis was conducted. Variables remaining in the final multivariable model: lower work ability (β = - 1.05, 95% CI - 1.40 to - 0.70; p < 0.0001) and consultation with a medical specialist for back pain in the preceding 3 months (β = 3.35, 95% CI 1.14 to 5.55; p < 0.003), which significantly predicted higher disability at 6 months (unadjusted R Patients with chronic LBP presenting to primary care with lower work ability and recent consultation with a medical specialist for LBP are more likely to have a worse prognosis; these are indicators to clinicians that standard conservative care may not adequately manage the patients' needs.
Sections du résumé
BACKGROUND
Predicting ongoing disability for chronic non-specific low back pain (LBP) is important to avoid prolonged disability.
OBJECTIVE
Determine predictors of disability at 6 month follow-up in patients with LBP at medium risk of ongoing disability.
METHODS
Baseline data was collected from 108 patients with medium-risk chronic non-specific LBP (mean age 50.4 years, SD 13.6) from six private chiropractic and physiotherapy clinics in Australia who took part in a randomised control trial. All patients received a pragmatic course of multimodal physical treatments [e.g., manual therapy (spinal manipulation or mobilization and/or soft tissue massage)] combined with advice, education and exercise. Baseline prognostic variables included sociodemographic, physical and psychological characteristics. Primary outcome was disability (Roland Morris Disability) at 6 month follow-up. Multivariable linear regression analysis was conducted.
RESULTS
Variables remaining in the final multivariable model: lower work ability (β = - 1.05, 95% CI - 1.40 to - 0.70; p < 0.0001) and consultation with a medical specialist for back pain in the preceding 3 months (β = 3.35, 95% CI 1.14 to 5.55; p < 0.003), which significantly predicted higher disability at 6 months (unadjusted R
CONCLUSION
Patients with chronic LBP presenting to primary care with lower work ability and recent consultation with a medical specialist for LBP are more likely to have a worse prognosis; these are indicators to clinicians that standard conservative care may not adequately manage the patients' needs.
Identifiants
pubmed: 32782008
doi: 10.1186/s12998-020-00328-3
pii: 10.1186/s12998-020-00328-3
pmc: PMC7422525
doi:
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
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