Skip to main content
Erschienen in: European Spine Journal 1/2014

01.01.2014 | Original Article

Prognosis of chronic low back pain in patients presenting to a private community-based group exercise program

verfasst von: Daniel Steffens, Mark J. Hancock, Chris G. Maher, Jane Latimer, Robert Satchell, Manuela Ferreira, Paulo H. Ferreira, Melissa Partington, Anna-Louise Bouvier

Erschienen in: European Spine Journal | Ausgabe 1/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To examine the prognosis and prognostic factors for patients with chronic low back pain presenting to a private, community-based, group exercise program.

Methods

A total of 118 consecutive patients with chronic LBP were recruited. Baseline assessments included socio-demographic characteristics, back pain history and clinical examination findings. Primary outcome measures were pain intensity and disability at 3, 6 and 12 months. Potential prognostic factors to predict pain intensity and disability at 12 months were assessed using a multivariate regression model.

Results

112 (95 %) participants were followed up at 12 months. The majority of participants were female (73 %), had high educational levels (82 %) and resided in suburbs with a high socio-economic status (99 %). Pain intensity improved markedly during the first 6 months (35 %) with further minimal reductions up to 12 months (39 %). Interestingly, disability improved to a greater degree than pain (48 % improvement at 6 months) and continued to improve throughout the 12 months (60 %). Baseline pain intensity accounted for 10 % of the variance in the 1 year pain outcomes. Duration of current episode, baseline disability and educational level accounted for 15 % of the variation in disability at 12 months.

Conclusions

During a period of 12 months, patients with chronic LBP presenting to a private, community-based, group exercise program improved markedly, with greater improvements in disability than pain. The predictors investigated accounted for only 10 and 15 % of pain and disability outcomes, respectively.
Literatur
1.
Zurück zum Zitat Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G (2006) European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15:192–300CrossRef Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G (2006) European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15:192–300CrossRef
2.
Zurück zum Zitat LdCM Costa, Maher CG, Hancock MJ, McAuley JH, Hebert RD, Costa LOP (2012) The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ 184(11):E613–E624CrossRef LdCM Costa, Maher CG, Hancock MJ, McAuley JH, Hebert RD, Costa LOP (2012) The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ 184(11):E613–E624CrossRef
3.
Zurück zum Zitat Burton AK, McClune TD, Clarke RD, Main CJ (2004) Long-term follow-up of patients with low back pain attending for manipulative care: outcomes and predictors. Man Ther 9(1):30–35PubMedCrossRef Burton AK, McClune TD, Clarke RD, Main CJ (2004) Long-term follow-up of patients with low back pain attending for manipulative care: outcomes and predictors. Man Ther 9(1):30–35PubMedCrossRef
4.
Zurück zum Zitat de Vet HCW, Heymans MW, Dunn KM, Pope DP, van der Beek AJ, Macfarlane GJ, Bouter LM, Croft OR (2002) Episodes of low back pain: a proposal for uniform definitions to be used in research. Spine 27:2409–2416PubMedCrossRef de Vet HCW, Heymans MW, Dunn KM, Pope DP, van der Beek AJ, Macfarlane GJ, Bouter LM, Croft OR (2002) Episodes of low back pain: a proposal for uniform definitions to be used in research. Spine 27:2409–2416PubMedCrossRef
5.
Zurück zum Zitat Grotle M, Foster NE, Dunn KM, Croft P (2010) Are prognostic indicators for poor outcome different for acute and chronic low back pain consulters in primary care? Pain 151:790–797PubMedCentralPubMedCrossRef Grotle M, Foster NE, Dunn KM, Croft P (2010) Are prognostic indicators for poor outcome different for acute and chronic low back pain consulters in primary care? Pain 151:790–797PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Hayden JA, Dunn KM, van der Windt DA, Shaw WS (2010) What is the prognosis of back pain? Best Pract Res Clin Rheumatol 24(2):167–179PubMedCrossRef Hayden JA, Dunn KM, van der Windt DA, Shaw WS (2010) What is the prognosis of back pain? Best Pract Res Clin Rheumatol 24(2):167–179PubMedCrossRef
7.
Zurück zum Zitat Hayden JA, Chou R, Hogg-Johnson S, Bombardier C (2009) Systematic reviews of low back pain prognosis had variable methods and results: guidance for future prognosis reviews. J Clin Epidemiol 62:781–796PubMedCrossRef Hayden JA, Chou R, Hogg-Johnson S, Bombardier C (2009) Systematic reviews of low back pain prognosis had variable methods and results: guidance for future prognosis reviews. J Clin Epidemiol 62:781–796PubMedCrossRef
8.
Zurück zum Zitat Costa Lda C, Maher CG, McAuley JH, Hancock MJ, Herbert RD, Refshauge KM, Henschke N (2009) Prognosis for patients with chronic low back pain: inception cohort study. BMJ 339:b3829PubMedCrossRef Costa Lda C, Maher CG, McAuley JH, Hancock MJ, Herbert RD, Refshauge KM, Henschke N (2009) Prognosis for patients with chronic low back pain: inception cohort study. BMJ 339:b3829PubMedCrossRef
9.
Zurück zum Zitat Melzack R (2001) Pain and the Neuromatrix in the Brain. J Dent Educ 65(12):1378–1382PubMed Melzack R (2001) Pain and the Neuromatrix in the Brain. J Dent Educ 65(12):1378–1382PubMed
10.
Zurück zum Zitat Bouvier AL (2008) Physiocise moviment for life: Backs, brains, breathing. Physiocise, Australia Bouvier AL (2008) Physiocise moviment for life: Backs, brains, breathing. Physiocise, Australia
11.
Zurück zum Zitat Bouvier AL, Fleming J (2010) The feel good body: 7 steps to easing aches and looking great. Harper Collins, Australia Bouvier AL, Fleming J (2010) The feel good body: 7 steps to easing aches and looking great. Harper Collins, Australia
12.
Zurück zum Zitat Pengel LHM, Refshauge KM, Maher CG (2004) Responsiveness of pain, disability, and physical impairment outcomes in patients with low back pain. Spine 29(8):879–883PubMedCrossRef Pengel LHM, Refshauge KM, Maher CG (2004) Responsiveness of pain, disability, and physical impairment outcomes in patients with low back pain. Spine 29(8):879–883PubMedCrossRef
13.
Zurück zum Zitat Roland M, Morris R (1983) A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine 8(2):141–144PubMedCrossRef Roland M, Morris R (1983) A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine 8(2):141–144PubMedCrossRef
14.
Zurück zum Zitat Scrimshaw SV, Maher CG (2001) Responsiveness of Visual Analogue and McGill Pain Scale Measures. J Manipulative Physiol Ther 24(8):501–504PubMedCrossRef Scrimshaw SV, Maher CG (2001) Responsiveness of Visual Analogue and McGill Pain Scale Measures. J Manipulative Physiol Ther 24(8):501–504PubMedCrossRef
15.
Zurück zum Zitat Deyo RA, Battie M, Beurskens AJ, Bombardier C, Croft P, Koes B, Malmivaara A, Roland M, Von Korff M, Waddell G (1998) Outcome measures for low back pain research. A proposal for standardized use. Spine 23(18):2003–2012PubMedCrossRef Deyo RA, Battie M, Beurskens AJ, Bombardier C, Croft P, Koes B, Malmivaara A, Roland M, Von Korff M, Waddell G (1998) Outcome measures for low back pain research. A proposal for standardized use. Spine 23(18):2003–2012PubMedCrossRef
16.
Zurück zum Zitat Westaway MD, Stratford PW, Binkley JM (1998) The patient-specific functional scale: validation of lts use in persons with neck dysfunction. J Orthop Sports Phys Ther 27(5):331–338PubMedCrossRef Westaway MD, Stratford PW, Binkley JM (1998) The patient-specific functional scale: validation of lts use in persons with neck dysfunction. J Orthop Sports Phys Ther 27(5):331–338PubMedCrossRef
17.
Zurück zum Zitat Miller RP, Kori S, Todd D (1991) The Tampa Scale: a measure of kinesiophobia. Clin J Pain 7(1):51–52CrossRef Miller RP, Kori S, Todd D (1991) The Tampa Scale: a measure of kinesiophobia. Clin J Pain 7(1):51–52CrossRef
18.
Zurück zum Zitat Harrell FE, Lee KL (1984) Regression modelling strategies for improved prognostic prediction. Stat Med 3:143–152PubMedCrossRef Harrell FE, Lee KL (1984) Regression modelling strategies for improved prognostic prediction. Stat Med 3:143–152PubMedCrossRef
19.
Zurück zum Zitat van Tulder MW, Koes BW, Metsemakers JFM, Bouter LM (1998) Chronic low back pain in primary care: a prospective study on the management and course. Fam Pract 15:126–132PubMedCrossRef van Tulder MW, Koes BW, Metsemakers JFM, Bouter LM (1998) Chronic low back pain in primary care: a prospective study on the management and course. Fam Pract 15:126–132PubMedCrossRef
20.
Zurück zum Zitat Lambeek LC, van Mechelen W, Knol DL, Loisel P, Anema JR (2010) Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. BMJ 340:c1035PubMedCentralPubMedCrossRef Lambeek LC, van Mechelen W, Knol DL, Loisel P, Anema JR (2010) Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. BMJ 340:c1035PubMedCentralPubMedCrossRef
21.
Zurück zum Zitat Guzman J, Esmail R, Karjalainen K, Malmivaara A, Irvin E, Bombardier C (2001) Multidisciplinary rehabilitation for chronic low back pain: systematic review. BMJ 322:1511–1516PubMedCrossRef Guzman J, Esmail R, Karjalainen K, Malmivaara A, Irvin E, Bombardier C (2001) Multidisciplinary rehabilitation for chronic low back pain: systematic review. BMJ 322:1511–1516PubMedCrossRef
22.
Zurück zum Zitat Bekkering GE, Hendriks HJM, van Tulder MW, Knol LD, Simmonds MJ, Oostendorp RAB, Bouter LM (2005) Prognostic factors for low back pain in patients referred for physiotherapy: comparing outcomes and varying modeling techniques. Spine 30:1881–1886PubMedCrossRef Bekkering GE, Hendriks HJM, van Tulder MW, Knol LD, Simmonds MJ, Oostendorp RAB, Bouter LM (2005) Prognostic factors for low back pain in patients referred for physiotherapy: comparing outcomes and varying modeling techniques. Spine 30:1881–1886PubMedCrossRef
Metadaten
Titel
Prognosis of chronic low back pain in patients presenting to a private community-based group exercise program
verfasst von
Daniel Steffens
Mark J. Hancock
Chris G. Maher
Jane Latimer
Robert Satchell
Manuela Ferreira
Paulo H. Ferreira
Melissa Partington
Anna-Louise Bouvier
Publikationsdatum
01.01.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 1/2014
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-2846-x

Weitere Artikel der Ausgabe 1/2014

European Spine Journal 1/2014 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.