Data-driven network analysis identified subgroup-specific low back pain pathways: a cross-sectional GLA:D Back study.
J Clin Epidemiol
; 153: 66-77, 2023 01.
Article
in En
| MEDLINE
| ID: mdl-36396075
ABSTRACT
OBJECTIVES:
To understand the physical, activity, pain, and psychological pathways contributing to low back pain (LBP) -related disability, and if these differ between subgroups.METHODS:
Data came from the baseline observations (n = 3849) of the "GLAD Back" intervention program for long-lasting nonspecific LBP. 15 variables comprising demographic, pain, psychological, physical, activity, and disability characteristics were measured. Clustering was used for subgrouping, Bayesian networks (BN) were used for structural learning, and structural equation model (SEM) was used for statistical inference.RESULTS:
Two clinical subgroups were identified with those in subgroup 1 having worse symptoms than those in subgroup 2. Psychological factors were directly associated with disability in both subgroups. For subgroup 1, psychological factors were most strongly associated with disability (ß = 0.363). Physical factors were directly associated with disability (ß = -0.077), and indirectly via psychological factors. For subgroup 2, pain was most strongly associated with disability (ß = 0.408). Psychological factors were common predictors of physical factors (ß = 0.078), pain (ß = 0.518), activity (ß = -0.101), and disability (ß = 0.382).CONCLUSIONS:
The importance of psychological factors in both subgroups suggests their importance for treatment. Differences in the interaction between physical, pain, and psychological factors and their contribution to disability in different subgroups may open the doors toward more optimal LBP treatments.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Low Back Pain
/
Chronic Pain
Type of study:
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
J Clin Epidemiol
Journal subject:
EPIDEMIOLOGIA
Year:
2023
Document type:
Article
Country of publication:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
/
US
/
USA