Journal
JOURNAL OF REHABILITATION MEDICINE
Volume 36, Issue 3, Pages 104-109Publisher
FOUNDATION REHABILITATION INFORMATION
DOI: 10.1080/16501970310019151
Keywords
low back pain; spinal manipulation; predictive analysis
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Objectives: To examine the relative influences of sociodemographic and episode-specific factors on change in low back pain intensity and self-rated disability. Methods: Of 204 patients with chronic low back pain, 102 were randomized to a combined manipulation, exercise and physician consultation group and 102 to a consultation-alone group. These groups were each divided into 2 clusters based on change in both pain intensity and self-rated disability at 1 year. The first cluster included patients whose symptoms clearly decreased, and the second those whose trouble persisted. Association between sociodemographic and episode-specific factors and poor recovery from low back pain and disability were evaluated by univariate and multivariate analysis. Results: Severe affective distress ( OR 3.81; 95% CI 1.3-10.8) predicted poor response to the manipulative treatment. Over a 25-day sick leave during previous year (19.64; 3.8-102.5), poor life control (9.40; 1.9-47.0), and generalized somatic symptoms (3.18; 0.9-11.6) were the risk factors for not benefiting from the informative approach. Conclusions: Psychosocial differences seem to be important determinants for treatment outcomes, and should be the focus of future studies.
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