Abstract
Purpose A considerable part of nonspecific low back pain patients suffer from a recurrence of symptoms after therapy cessation. The aim of this study was to evaluate the predictive value of active and passive treatments and treatment modalities on a recurrence of back pain after cessation of medically prescribed therapy. Methods Patients with unspecific low back pain from a health- and therapy-center were included. Treatments and treatment modalities as therapy measures were monitored and categorized as active or passive measures. During the year after therapy cessation, patients were monitored to retrieve information about recurrence of symptoms. Patients were dichotomized (recurrence versus no recurrence). An ROC-Analysis was used to determine optimal cut-offs for relevant treatment characteristics’ impact on recurrence risk. The relative risk for a recurrence was calculated based on Chi 2 -test. Results Data from 96 patients (56f, 49±11 years) were analysed. A total of 34 patients had recurring back pain. The frequency of active treatment differed significantly between groups with or without recurrence. A therapy frequency of 1.45 active treatments/week was a sensitive cut-off (sensitivity: 0.73) to discriminate the recurrence groups. Participants with a therapy frequency of less than 1.45 treatments per week showed an 82% increased relative recurrence risk (RR: 1.824 (95%-CI: 1.077-3.087)). Conclusions The results empathize the importance of active treatments (i.e. exercise) in the therapy and (secondary) prevention of unspecific low back pain. Less than 1.45 active treatment sessions/week increases the 1-year-risk of a recurrence by 82%.
Clinical Perspective: How Do Clinical Test Results Differentiate Chronic and Subacute Low Back Pain Patients from "Non-Patients"?
