The authors declare to have no competing financial or non-financial interests. We want to disclose the following as potential conflicts of interest: The Danish cohort study was financially supported by the Danish Chiropractors’ Foundation as is Alice Kongsted’s position. The Swedish cohort study was funded by the Swedish Chiropractors’ Association and the European Chiropractors’ Union, and the original UK study was funded by the Anglo-European College of Chiropractic and the British Chiropractic Association. No grants were received in relation to this post-hoc analysis of these cohort data.
All authors participated in the design of the study, made revisions of the manuscript and approved the final version. AK initiated the work, performed the analyses and drafted the manuscript.
Low back pain (LBP) is the world’s leading cause of disability and yet poorly understood. Cross-national comparisons may motivate hypotheses about outcomes being condition-specific or related to cultural differences and can inform whether observations from one country may be generalised to another. This analysis of data from three cohort studies explored whether characteristics and outcomes differed between LBP patients visiting chiropractors in Sweden, Denmark and the UK.
LBP patients completed a baseline questionnaire and were followed up after 3, 5, 12 and 26 weeks. Outcomes were LBP intensity (0–10 scales) and LBP frequency (0–7 days the previous week). Cohort differences were tested in mixed models accounting for repeated measures. It was investigated if any differences were explained by different baseline characteristics, and interaction terms between baseline factors and nations tested if strength of prognostic factors differed across countries.
The study sample consisted of 262, 947 and 453 patients from Sweden, Denmark and the UK respectively. Patient characteristics were largely similar across cohorts although some statistically significant differences were observed. The clinical course followed almost identical patterns across nations and small observed differences were not present after adjusting for baseline factors. The associations of LBP intensity and episode duration with outcome differed in strength between countries.
Chiropractic patients with low back pain had similar characteristics and clinical course across three Northern European countries. It is unlikely that culture have substantially different impacts on the course of LBP in these countries and the results support knowledge transfer between the investigated countries.
Da C, Menezes Costa L, Maher CG, Hancock MJ, McAuley JH, Herbert RD, et al. The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ. 2012;184(11):E613–24. CrossRef
Kongsted A, Vach W, Axo M, Bech RN, Hestbaek L. Expectation of recovery from low back pain: a longitudinal cohort study investigating patient characteristics related to expectations and the association between expectations and 3-month outcome. Spine (Phila Pa 1976). 2014;39(1):81–90. CrossRef
Danish National Commitee on Biomedical Research Ethics. Guidelines about Notification. http://www.cvk.sum.dk/English/guidelinesaboutnotification.aspx
Lemeunier N, Kongsted A, Axen I. Prevalence of pain-free weeks in chiropractic subjects with low back pain-a longitudinal study using data gathered with text messages. Chiropr Man Ther. 2011;19:28. CrossRef
Intelligent Communication with SMS-Track [ http://www.sms-track.com]
Nielsen OL, Kongsted A, Christensen HW. The Chiropractic Profession in Denmark 2010–2014. A descriptive report. 2015.
- Low back pain patients in Sweden, Denmark and the UK share similar characteristics and outcomes: a cross-national comparison of prospective cohort studies
- BioMed Central
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