Minimal Clinically Important Change for Pain Intensity and Disability in Patients With Nonspecific Low Back Pain

AbstractBackground and aimsThe Core Outcome Measures Index (COMI) is a short, self-reported questionnaire for assessing important outcomes in patients with low back pain (LBP). The present study was conducted to explore the responsiveness and longitudinal validity of the Persian COMI (COMI-P) in patients with non-specific chronic LBP.MethodsIn this prospective cohort study of patients with non-specific chronic LBP receiving physiotherapy, patients completed a booklet containing the COMI-P, Persian Functional Rating Index (FRI-P), and a visual analogue scale (VAS) for pain before and after the end of ten-sessions of physiotherapy. Patients also completed a global rating of change scale (GRCS) at the end of the physiotherapy. Responsiveness was examined by means of internal responsiveness methods [t-test, standard effect size (SES); standardized response mean (SRM), and Guyatt responsiveness index (GRI)] and external responsiveness methods [correlation with external criteria and receiver operating characteristics (ROC) curve].ResultsFifty patients with a mean age of 50.62 ± 13.8 years participated. The paired t-test showed significant changes in COMI-P scores (p < 0.001). The effect sizes for COMI-P were large (range 0.96–1.23). The score changes for the COMI-P revealed significant correlations with FRI-P (r = 0.67, p < 0.001), the VAS (r = 0.65, p < 0.001), and the GRCS (r = 0.34, p = 0.02). The COMI-P change scores showed excellent correlation with the dichotomized smallest detectable change (SDC) criterion (r = 0.83, p < 0.001). The ROC area under the curve for the COMI-P based on the dichotomized SDC criterion was perfect. The minimal clinically important change was estimated 2.15 points (sensitivity 94% and specificity 100%).ConclusionsThe COMI-P appears to have responsiveness and longitudinal validity in detecting changes after physiotherapy for non-specific chronic LBP. An improvement of 2.15 points in COMI-P total score is required to be interpreted as minimally clinically important change in individual patients.

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99 RESPONSIVENESS AND MINIMAL CLINICALLY IMPORTANT CHANGE OF PERFORMANCE TESTS IN CHRONIC LOW BACK PAIN

European Journal of Pain ◽

10.1016/s1090-3801(09)60102-6 ◽

2009 ◽

Vol 13 (S1) ◽

Author(s):

R.J.E.M. Smeets ◽

I.E. Andersson ◽

C.C. Lin

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Important Change ◽

Low Back ◽

Performance Tests ◽

Clinically Important Change

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Minimally Clinically Important Change in the Activity Measure for Post Acute Care (AM-PAC), a Generic Patient-Reported Outcome Tool, in People With Low Back Pain

Physical Therapy ◽

10.1093/ptj/pzx083 ◽

2017 ◽

Author(s):

Natalie Lee ◽

Nicolas R. Thompson ◽

Sandra Passek ◽

Mary Stilphen ◽

Irene L. Katzan

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Acute Care ◽

Patient Reported Outcome ◽

Important Change ◽

Low Back ◽

Patient Reported ◽

Outcome Tool ◽

Clinically Important Change ◽

Activity Measure

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Responsiveness of Minimal Clinically Important Change for the Persian Functional Rating Index in Patients with Chronic Low Back Pain

Asian Spine Journal ◽

10.31616/asj.2018.0107 ◽

2019 ◽

Vol 13 (1) ◽

pp. 111-118 ◽

Cited By ~ 3

Author(s):

Noureddin Nakhostin Ansari ◽

Shiva Komesh ◽

Soofia Naghdi ◽

Zahra Fakhari ◽

Parisa Alaei

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Important Change ◽

Low Back ◽

Clinically Important Change

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Responsiveness of the Bournemouth Questionnaire in Determining Minimal Clinically Important Change in Subgroups of Low Back Pain Patients

Spine ◽

10.1097/brs.0b013e3181cc006b ◽

2010 ◽

Vol 35 (19) ◽

pp. 1801-1806 ◽

Cited By ~ 27

Author(s):

David Newell ◽

Jennifer E. Bolton

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Important Change ◽

Low Back ◽

Bournemouth Questionnaire ◽

Clinically Important Change ◽

Pain Patients

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Rasterstereographic Analysis of Lateral Shift in Patients with Lumbar Disc Herniation: A Case Control Study

Advances in Orthopedics ◽

10.1155/2018/6567139 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8

Author(s):

Britta K. Krautwurst ◽

Jürgen R. Paletta ◽

Sylvia Mendoza ◽

Adrian Skwara ◽

Melvin Mohokum

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Pelvic Tilt ◽

Lumbar Disc ◽

Lateral Shift ◽

Healthy Controls ◽

Low Back

Objective. Detection of a lateral shift (LS) in patients with diagnosed disc herniation compared to healthy controls. Summary of Background Data. A specific lateral shift (LS) pattern is observed in patients with disc herniation and low back pain, as shown in earlier studies. Methods. Rasterstereography (RS) was used to investigate the LS. Thirty-nine patients with lumbar disc herniation diagnosed by radiological assessment and low back pain and/or leg pain (mean age 48.2 years, mean BMI 28.5, 28 males and 11 females) and 36 healthy controls (mean age 47.4 years, mean BMI 25.7, 25 males and 11 females) were analysed. LS, pelvic tilt, pelvic inclination, lordotic angle, and trunk torsion were assessed. Results. The patient group showed a nonsignificant increase in LS, that is, 5.6 mm compared to the healthy controls with 5.0 mm (p = 0.693). However, significant differences were found between groups regarding pelvic tilt in degrees (patients 5.9°, healthy controls 2.0°; p = 0.016), trunk torsion (patients 7.5°, controls 4.5°; p = 0.017), and lordotic angle (patients 27.5°, healthy controls 32.7°; p = 0.022). The correlation between pain intensity and the FFbH-R amounted 0.804 (p = < 0.01), and that between pain intensity and the pain disability index was 0.785 (p < 0.01). Discussion. Although some studies have illustrated LS with disc herniation and low back pain, the present findings demonstrate no significant increase in LS in the patient group compared to healthy controls. Conclusion. The patients with lumbar disc herniation did not demonstrate an increased LS compared to healthy controls. Other parameters like pelvic tilt and inclination seemed to be more suitable to identify changes in posture measured by RS in patients with low back pain or disc herniation.

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

Scientific Reports ◽

10.1038/s41598-021-97569-w ◽

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.

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To Study the effect of Traditional Back Exercises vs Exercise Ball Exercise on Pain Intensity, Core Endurance and Limitation of Activities in Individuals with Nonspecific Low Back Pain: A Comparative Study

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i36a31934 ◽

2021 ◽

pp. 117-123

Author(s):

Jay Kumar Soni ◽

Edrish Contractor

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Comparative Study ◽

Pain Intensity ◽

Core Stability ◽

Low Back ◽

Significant Difference ◽

Group A ◽

Group B ◽

Swiss Ball

Aims: Non specific Low back pain is defined as pain without any known pathology which affects almost all the leading occupation where body's awkward posture, twisting and stress forces are commonly encountered across the globe and it is highly prevalent 60% to 70% in a year. Studies have shown various exercise regimen individual effect on the same but superiority of regimen out of these is not clear. Study Design: Comparative Study Place and Duration of Study: Ahmedabad Institute of Medical Sciences, Duration 2013-15 Objective: To assess and compare the effect of core stability exercise, back school program and Swiss ball exercise on Pain, core endurance and Functional disability. Methodology: A group of 24 patients having non-specific low back pain between age groups 18-40 were randomly selected and allocated in to two groups. Group A(n=12) received traditional exercise whereas Swiss ball exercise was given to Group B(n=12). The subjects were treated for two weeks. Baseline data for VAS, Core endurance and MODI were taken on day1 and at the end of two weeks Result: The results were analyzed by wilcoxon signed rank test within both groups. Both groups showed significant improvement in VAS, core endurance and MODI at the end of 2weeks.Comparison between both the Group A and Group B was done by Mann- whitney U test and statistically no significant difference was seen in VAS, core endurance and MODI between the groups Conclusion: The study concluded that both the exercises are equally effective in reducing pain intensity, improves core endurance and functional status in subjects with non specific low back pain

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Meditation for adults with non-specific low back pain: a systematic review and meta-analysis

Scandinavian Journal of Pain ◽

10.1515/sjpain-2021-0096 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Larissa O. Soares ◽

Giovanni E. Ferreira ◽

Leonardo O. P. Costa ◽

Leandro C. Nogueira ◽

Ney Meziat-Filho ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Usual Care ◽

Pain Intensity ◽

Cochrane Library ◽

Low Back ◽

Short Term ◽

Minimal Intervention ◽

Better Than

Abstract Objectives We aim to determine the effectiveness of meditation for adults with non-specific low back pain. Methods We searched PubMed, EMBASE, PEDro, Scopus, Web of Science, Cochrane Library, and PsycINFO databases for randomized controlled trials that investigated the effectiveness of meditation in adults with non-specific low back pain. Two reviewers rated risk of bias using the PEDro scale and the certainty of the evidence using the GRADE approach. Primary outcomes were pain intensity and disability. Results We included eight trials with a total of 1,234 participants. Moderate-certainty evidence shows that meditation is better than usual care for disability at short-term (SMD = −0.22; 95% CI = −0.42 to −0.02). We also found that meditation is better than usual care for pain intensity at long-term (SMD = −0.28; 95% CI = −0.54 to −0.02). There is no significant difference for pain intensity between meditation and minimal intervention or usual care at short and intermediate-term. We did not find differences between meditation and minimal intervention for disability at intermediate-term or usual care in any follow-up period. Conclusions We found small effect sizes and moderate-certainty evidence that meditation is slightly better than minimal intervention in the short-term for disability. Low-certainty of evidence suggests that meditation is slightly better than usual care for pain in the long-term. Meditation appears to be safe with most trials reporting no serious adverse events.

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