Predictors of functional outcome in patients with chronic low back pain undergoing back school, individual physiotherapy or spinal manipulation.
Eur J Phys Rehabil Med
; 48(3): 371-8, 2012 Sep.
Article
in En
| MEDLINE
| ID: mdl-22569488
ABSTRACT
BACKGROUND:
Recent studies on chronic low back pain (cLBP) rehabilitation suggest that predictors of treatment outcome may be differ according to the considered conservative treatment.AIM:
To identify predictors of response to back school (BS), individual physiotherapy (IP) or spinal manipulation (SM) for cLBP. POPULATION outpatients with cLBP.SETTING:
Outpatient rehabilitation department.DESIGN:
Retrospective analysis from a randomized trial.METHODS:
Two hundred and ten patients with cLBP were randomly assigned to either BS, IP or SM; the Roland Morris Disability Questionnaire (RM) was assessed before and after treatment those who decreased their RM score <2.5 were considered non-responders. Baseline potential predictors of outcome included demographics, general and cLBP history, life satisfaction.RESULTS:
Of the 205 patients who completed treatment (140/205 women, age 58+14 years), non-responders were 72 (34.2%). SM showed the highest functional improvement and the lowest non-response rate. In a multivariable logistic regression, lower baseline RM score (OR 0.82, 95% CI 0.76-0.89, P<0.001) and received treatment (OR 0.32, 95% CI 0.21-0.50, P<0.001) were independent predictors of non-response. Being in the lowest tertile of baseline RM score (<6) predicted non response to treatment for BS and IP, but not for SM (same risk for all tertiles).CONCLUSIONS:
In our patients with cLBP lower baseline pain-related disability predicted non-response to physiotherapy, but not to spinal manipulation. CLINICAL REHABILITATION IMPACT Our results suggest that, independent form other characteristics, patients with cLBP and low pain-related disability should first consider spinal manipulation as a conservative treatment.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patient Education as Topic
/
Physical Therapy Modalities
/
Low Back Pain
/
Manipulation, Spinal
/
Disability Evaluation
/
Exercise Therapy
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Eur J Phys Rehabil Med
Journal subject:
MEDICINA FISICA
/
REABILITACAO
Year:
2012
Document type:
Article
Affiliation country:
Italy