scholarly journals Factors associating with disability of non-specific low back pain in different subgroups: A hierarchical linear regression analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takahiro Miki ◽  
Daisuke Higuchi ◽  
Tsuneo Takebayashi ◽  
Mina Samukawa
Keyword(s):  
Regression Analysis ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Psychosocial Factors ◽  
Self Efficacy ◽  
Explanatory Power ◽  
Low Back ◽  
Acute Group ◽  
Pain Catastrophising

AbstractThis study aimed to explore factors associating with disability, which means physical impairment affecting a person’s mobility, capacity, stamina, or agility, of non-specific low back pain (NSLBP) of the acute and non-acute groups. Two hundred thirty-five patients with NSLBP of less than 8 weeks’ duration as acute groups (n = 124) and more than 8 weeks’ duration as non-acute group (n = 111) were recruited. It was collected data on pain intensity, disability and psychosocial factors, including pain catastrophising, fear of movement and pain self-efficacy. Disability was measured Roland Morris Disability Questionnaire. A hierarchical multiple regression analysis was performed to analyse factors associating with disability of the acute and non-acute groups. The Result was that explanatory power increased with each additional variable of the order of demographic characteristics, pain intensity and psychosocial factors for both groups. Pain intensity, pain catastrophising and pain self-efficacy had significant explanatory power, with pain self-efficacy having the most significant association on the acute group. Only pain self-efficacy having the most significant association on disability of the non-acute group. In conclusion, the factors associating with disability differed depending on the duration of the disease, and pain self-efficacy might be one of the factors associating with disability of patients with NSLBP.

scholarly journals Factors Affecting Disability With Nonspecific Low Back Pain in Different Subgroups: A Hierarchical Linear Regression Analysis

2021 ◽  
Author(s):  
Takahiro Miki ◽  
Daisuke Higuchi ◽  
Tsuneo Takebayashi ◽  
Mina Samukawa
Keyword(s):  
Regression Analysis ◽  
Pain Intensity ◽  
Psychosocial Factors ◽  
Explanatory Power ◽  
Demographic Characteristics ◽  
Low Back ◽  
Factors Affecting ◽  
Additional Variable ◽  
Chronic Group ◽  
Acute Group

Abstract Purpose: To systematically explore how disability is influenced with layers　(demographic level, pain level and psychosocial factors) in nonspecific low back pain (NSLBP) in different subgroups.Methods: This is a cross-sectional study that compared two different subgroups in NSLBP at two hospitals. Hierarchical multiple regression analysis was performed to analyse factors affecting disability in different groups (overall group, acute group and subacute/chronic group).Results: In the overall group (n = 235), explanatory power increased with each additional variable in the order of demographic characteristics, pain intensity and psychosocial factors. Pain intensity (ß = 0.219), Pain Catastrophising Scale (PCS) (ß = 0.175) and Pain Self-Efficiency Questionnaire (PSEQ) (ß = −0.370) were significantly associated with disability. In the acute group (n = 65), explanatory power improved with each additional variable for the disability in the order of demographic characteristics, pain intensity and psychosocial factors. Ultimately, pain intensity and PSEQ had significant explanatory power, with pain having the most influence. However, in the subacute/chronic group (n = 170), explanatory power increased with each additional variable in the order of demographic characteristics, pain intensity and psychosocial factors and all, including psychosocial factors, had a strong impact, with self-efficacy having the most substantial impact on disability.Conclusion: Depending on the duration of the disease, the factors affecting the disability differed, with pain having more influence than psychosocial factors in the acute phase and psychosocial factors having more influence in the chronic phase.

scholarly journals Rasch Analysis Supports the Use of the Pain Self-Efficacy Questionnaire

2014 ◽  
Vol 94 (1) ◽  
pp. 91-100 ◽  
Author(s):  
Flavia Di Pietro ◽  
Mark J. Catley ◽  
James H. McAuley ◽  
Luke Parkitny ◽  
Christopher G. Maher ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Internal Consistency ◽  
Self Efficacy ◽  
Rasch Analysis ◽  
Item Bias ◽  
Measurement Properties ◽  
Low Back ◽  
Pain Duration

Background The Pain Self-Efficacy Questionnaire (PSEQ) is used by physical therapists in clinical practice and in research. However, current understanding of the PSEQ's measurement properties is incomplete, and investigators cannot be confident that it provides unbiased information on patient self-efficacy. Objective The aims of this study were: (1) to investigate the scale properties of the PSEQ using Rasch analysis and (2) to determine whether age, sex, pain intensity, pain duration, and pain-related disability bias function of the PSEQ. Design This was a retrospective study; data were obtained from 3 existing studies. Methods Data were combined from more than 600 patients with low back pain of varying duration. Rasch analysis was used to evaluate targeting, category ordering, unidimensionality, person fit, internal consistency, and item bias. Results There was evidence of adequate category ordering, unidimensionality, and internal consistency of the PSEQ. Importantly, there was no evidence of item bias. Limitations The PSEQ did not adequately target the sample; instead, it targeted people with lower self-efficacy than this population. Item 7 was hardest for participants to endorse, showing excessive positive misfit to the Rasch model. Response strings of misfitting persons revealed older participants and those reporting high levels of disability. Conclusions The individual items of the PSEQ can be validly summed to provide a score of self-efficacy that is robust to age, sex, pain intensity, pain duration, and disability. Although item 7 is the most problematic, it may provide important clinical information and requires further investigation before its exclusion. Although the PSEQ is commonly used with people with low back pain, of whom the sample in this study was representative, the results suggest it targets patients with lower self-efficacy than that observed in the current sample.

scholarly journals Results of a feasibility randomised clinical trial on pain education for low back pain in Nepal: the Pain Education in Nepal-Low Back Pain (PEN-LBP) feasibility trial

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026874 ◽  
Author(s):  
Saurab Sharma ◽  
Mark P Jensen ◽  
G Lorimer Moseley ◽  
J Haxby Abbott
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Outcome Measures ◽  
Randomised Clinical Trial ◽  
Education Intervention ◽  
Low Back ◽  
Pain Education ◽  
Pain Catastrophising

ObjectivesThe aims of this study were to: (1) develop pain education materials in Nepali and (2) determine the feasibility of conducting a randomised clinical trial (RCT) of a pain education intervention using these materials in Nepal.DesignA two-arm, parallel, assessor-blinded, feasibility RCT.SettingA rehabilitation hospital in Kathmandu, Nepal.ParticipantsForty Nepalese with non-specific low back pain (mean [SD] age 41 [14] years; 12 [30%] women).InterventionsEligible participants were randomised, by concealed, 1:1 allocation, to one of two groups: (1) a pain education intervention and (2) a guideline-based physiotherapy active control group intervention. Each intervention was delivered by a physiotherapist in a single, 1-hour, individualised treatment session.Primary outcome measuresThe primary outcomes were related to feasibility: recruitment, retention and treatment adherence of participants, feasibility and blinding of outcome assessments, fidelity of treatment delivery, credibility of, and satisfaction with, treatment. Assessments were performed at baseline and at 1 week post-treatment.Secondary outcome measuresPain intensity, pain interference, pain catastrophising, sleep disturbance, resilience, global rating of change, depression and quality of life. Statistical analyses were conducted blind to group allocation.ResultsForty participants were recruited. Thirty-eight participants (95%) completed the 1-week post-treatment assessment. Most primary outcomes surpassed the a priori thresholds for feasibility. Several findings have important implications for designing a full trial. Secondary analyses suggest clinical benefit of pain education over the control intervention, with larger decrease in pain intensity (mean difference=3.56 [95% CI 0.21 to 6.91]) and pain catastrophising (mean difference=6.16 [95% CI 0.59 to 11.72]) in the pain education group. Pain intensity would seem an appropriate outcome for a full clinical trial. One minor adverse event was reported.ConclusionWe conclude that a full RCT of pain education for back pain in Nepal is feasible and warranted.Trial registration numberNCT03387228; Results.

Influence of the Generation of Motor Mental Images on Physiotherapy Treatment in Patients with Chronic Low Back Pain

2020 ◽  
Vol 4;23 (7;4) ◽  
pp. E399-E408
Author(s):  
Roy La Touche
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Motor Imagery ◽  
Chronic Low Back Pain ◽  
Self Efficacy ◽  
Therapeutic Education ◽  
Low Back ◽  
Psychological Variables ◽  
Visual Motor

generating kinesthetic and visual motor imagery. Objectives: The main aim of this study was to determine whether the ability to generate mental motor imagery (MIab) influences psychological, motor, and disability variables in patients with NCLBP. The secondary aim was to determine whether an approach based on therapeutic exercise (TE) and therapeutic education (TEd) could improve the MIab in those patients with less ability to perform it. Study Design: Cross-sectional and quasiexperimental study. Setting: Physical Therapy Unit of primary health care center in Madrid, Spain. Methods: A total of 68 patients were divided into 2 groups according to a greater (n = 34) or lesser (n = 34) MIab. Treatment was based on TEd and TE for the group with less ability to generate kinesthetic and visual motor imagery. The outcome measures were imagery requested time, self-efficacy, disability, pain intensity, lumbar strength, psychological variables, and MIab. Results: The group with lesser MIab showed lower levels of self-efficacy (P = 0.04; d, −0.47) and lower levels of lumbar strength and extension strength (P = 0.04; d, −0.46 and P = 0.02; d, −0.52, respectively). After the intervention with TE and TEd, MIab (both kinesthetic and visual) improved significantly, with a moderate to large effect size (P ≤ 0.01; d, −0.80 and P ≤ 0.01; d, −0.76, respectively), as did pain intensity, lumbar strength, disability, and psychological variables (P < 0.05), but not levels of self-efficacy (P > 0.05). Based on the results, the patients with NCLBP with lesser MIab achieved lower levels of self-efficacy and lower strength levels. Limitations: The results of this study should be interpreted with caution because of its quasiexperimental design and a bias selection. Conclusions: A clinical TE approach, coupled with a TEd program, resulted in significant improvement in MIab (both kinesthetic and visual), reduced pain intensity, increased lumbar strength, reduced disability, and improved psychological variables, but it did not significantly improve self-efficacy levels in the patients with NCLBP. Key words: Chronic low back pain, motor imagery, disability, lumbar strength

scholarly journals Is there a relationship between self-efficacy, disability, pain and sociodemographic characteristics in chronic low back pain? A multicenter retrospective analysis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Silvano Ferrari ◽  
Carla Vanti ◽  
Marta Pellizzer ◽  
Luca Dozza ◽  
Marco Monticone ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Retrospective Analysis ◽  
Chronic Low Back Pain ◽  
Educational Level ◽  
Self Efficacy ◽  
Clinical Characteristics ◽  
Female Gender ◽  
Low Back

Abstract Background Pain-related self-efficacy is defined as the beliefs held by people with chronic pain that certain activities can be carried out despite the pain. Poor self-efficacy is an obstacle to the recovery and predicts long-term disability. The aims of this study are to investigate the prevalence of poor pain self-efficacy in Italian subjects with chronic low back pain (LBP), and to inquire the relationships between self-efficacy, disability, pain, and main demographic and clinical characteristics. Methods A secondary multicenter retrospective analysis was done on 310 outpatients with chronic non-specific LBP. The pain self-efficacy measured with the Pain Self-Efficacy Questionnaire (PSEQ), the disability measured with the Roland & Morris Disability Questionnaire, and the pain intensity measured with the Numerical Rating Scale were considered variables to investigate, whereas demographic and clinical variables were considered predictors or potential confounders. A 40/60 PSEQ score was adopted as cut-off to distinguish between good and poor self-efficacy. Results 199 subjects (64.2% of the sample) showed poor self-efficacy. The odds of having poor self-efficacy appeared significantly related to female gender (OR = 1.80, 95%CI [1.12;2.90]; p = 0.015) and drugs use (OR = 1.68, 95%CI [1.06;2.70]; p = 0.029). Significant relationships also emerged between disability and higher age (β = 0.07, 95%CI [0.01; 0.12]; p = 0.02), being female (β = 1.80, 95%CI [0.32;3.29]; p = 0.018), low educational level (β = − 1.68, 95%CI [− 2.59;-3.29]; p < 0.001), higher height (β = − 0.08, 95%CI [− 0.158;-0.002]; p = 0.045), pain duration [mos] (β = 0.01, 95%CI [0.001;0.021]; p = 0.041), and drugs use (β = 2.86, 95%CI [1.44;4.27]; p < 0.001). The amount of pain appeared significantly related to educational level (β = − 0.47, 95%CI [− 0.76;-0.182]; p < 0.001), smoking (β = 0.56, 95%CI [0.09; 1.03]; p = 0.021), height (β = − 0.03, 95%CI [− 0.05; − 0.002]; p = 0.036), and drugs use (β = 0.81, 95%CI [0.399;1.22]; p < 0.001). No significant correlation appeared among weight, body mass index, and referred pain neither in relation to self-efficacy, nor in relation to pain/disability. Conclusions The majority of our sample, composed of Italian people complained of chronic LBP, shows poor self-efficacy. Female gender and drugs use are significantly related to poor self-efficacy, low educational level negatively influences the amount of perceived pain and disability, and older age and smoking are related to disability and pain intensity, respectively. The knowledge of these sociodemographic and clinical characteristics potentially influencing chronic LBP may be useful to address more efforts towards the most negatively impacted subjects, among the entire population complained of chronic LBP.

Pain Self-Efficacy and Fear of Movement are Similarly Associated with Pain Intensity and Disability in Italian Patients with Chronic Low Back Pain

Pain Practice ◽  
2015 ◽  
Vol 16 (8) ◽  
pp. 1040-1047 ◽  
Author(s):  
Silvano Ferrari ◽  
Alessandro Chiarotto ◽  
Marta Pellizzer ◽  
Carla Vanti ◽  
Marco Monticone
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Chronic Low Back Pain ◽  
Self Efficacy ◽  
Low Back ◽  
Fear Of Movement

Psycho-sensory relationships in chronic pain

2020 ◽  
pp. 204946372093392
Author(s):  
Daniel S Harvie ◽  
Daniela Vasco ◽  
Michele Sterling ◽  
Samantha Low-Choy ◽  
Nils G Niederstrasser
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Standard Deviation ◽  
Neck Pain ◽  
Pain Intensity ◽  
Persistent Pain ◽  
Low Back ◽  
Standard Deviation Increase ◽  
Psychological Variables ◽  
Pain Catastrophising

Background: Psychological variables contribute to pain- and injury-related outcomes. We examined the hypothesis that anatomical spread and intensity of persistent pain relate to anxiety-related variables: generalised anxiety, fear of pain and pain catastrophising. Methods: An online survey was used to gather data from 413 women with persistent pain (low back pain, n = 139; fibromyalgia syndrome, n = 95; neck pain, n = 55; whiplash, n = 41; rheumatoid arthritis, n = 37; migraine, n = 46). The spread and intensity of pain were assessed using the McGill pain chart and a Numerical Rating Scale. A Bayesian Structural Equation Model assessed if the intensity and spread of pain increased with anxiety-related variables. Men were also surveyed (n = 80), but the sample size was only sufficient for analysing if their data were consistent with the model for women. Results: Across subgroups of women, one standard deviation increase in catastrophising, generalised anxiety and fear corresponded to 27%, 7% and −1% additional pain areas and a 1.1, 0 and –0.1 change in pain intensity (on 0–10 scale), respectively. Overall, our clinical significance criterion – a 30% shift in pain variable in relation to one standard deviation increase in psychological variable – was not met. However, in subgroups it was met for pain spread (low back pain, neck pain and migraine) and pain intensity (migraine and neck pain) in relation to pain catastrophising. The model generally had low goodness-of-fit to men. Conclusion: These data support a meaningful relationship between some anxiety-related variables and pain in women for some conditions. Since the model did not consistently fit the men, we may conclude that the relationships are moderated by sex. Clinician attention to psychological variables as potential contributing factors can be justified; however, research is needed to understand the relationship and whether psychological treatment can reduce pain.

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