Identifying prognostic factors to determine the level of recovery in servicemembers with chronic low back pain: a prospective cohort study.

2020 ◽  
Author(s):  
Bianca Maria Pietertje Mourits ◽  
Mariette Zwanette Meulekamp ◽  
Peter van der Wurff ◽  
Cees Lucas
Keyword(s):  
Cohort Study ◽  
Low Back Pain ◽  
Prognostic Factors ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Rehabilitation Program ◽  
Service Members ◽  
Low Back ◽  
Regression Analyses

Abstract Background In the Dutch Armed Forces (DAF), low back pain is the third most reported musculoskeletal disorder. For the prognosis of chronic low back pain (CLBP) only limited evidence is available. This observation results in a lack of clarity on prognostic factors that might affect recovery from CLBP in service members.The main objective is to identify general and military-related factors that are associated with the level of recovery in DAF service members with CLBP who followed a rehabilitation program. Methods One hundred five consecutive service members with CLBP who completed the rehabilitation program have been included in this prospective observational cohort study. The primary outcome measurement, level of disability, was used to distinguish a recovered and non-recovered group. Level of pain and self-perceived recovery were used as secondary outcome measurements. Disability and pain were measured at baseline and 12 weeks follow-up and self-perceived recovery only at follow-up. Differences were evaluated within and between the groups using the Student’s t-test, according to the normality of the data distribution. Bivariate logistic regression analyses were used for identifying the prognostic factors related to various outcomes of recovery. Results After following the rehabilitation program, 64.8% of the service members recovered from CLBP. In the recovered group, there are significant effect sizes of -6.72 (CI: -7.57 - -5.87) in the level of disability and − 2.58 (CI: -3.17- -1.98) in level of pain, whereas the non-recovered group shows a non-significant effect size of -0.49 (CI: -1.27 - -0.29) in level of disability and a significant effect size of -0.94 (CI: -1.62 - -0.25) in level of pain. The self-perceived recovery in the recovered group is on average “much improved” and in the non-recovered group “slightly improved”. The results of the bivariate regression analyses show no significant independent prognostic factors related to recovery. Conclusion In this study, no significant independent prognostic factors could be identified that are associated to the various outcomes of recovery in service members with CLBP who followed a rehabilitation program.

scholarly journals Identifying prognostic factors to determine the level of recovery in servicemembers with chronic low back pain: A prospective cohort study

2021 ◽  
pp. 1-9
Author(s):  
B.M.P. Mourits ◽  
M.Z. Meulekamp ◽  
P. van der Wurff ◽  
C. Lucas
Keyword(s):  
Low Back Pain ◽  
Prognostic Factors ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Rehabilitation Program ◽  
Service Members ◽  
Secondary Outcome ◽  
Low Back ◽  
Regression Analyses ◽  
Related Factors

OBJECTIVE: The main objective of this study was to identify general and military-related factors that are associated with the level of recovery in Dutch service members with chronic low back pain (CLBP) who followed a rehabilitation program. MATERIAL AND METHOD: One hundred five consecutive service members with CLBP were included in this study. The level of disability, was used to distinguish a recovered and non-recovered group. Level of pain and self-perceived recovery were used as secondary outcome measurements. Differences were evaluated within and between the groups using the Student’s t-test Bivariate logistic regression analyses were used for identifying the prognostic factors related to various outcomes of recovery RESULTS: After following the rehabilitation program, 64.8% of the service members recovered from CLBP. The recovered group, demonstrated significant effect sizes in disability and in pain The non-recovered group showed on disability a non-significant effect and in pain a significant effect. The self-perceived recovery in the recovered group was “much improved” and the non-recovered group “slightly improved”. The results of the bivariate regression analyses showed no significant independent prognostic factors related to recovery. CONCLUSIONS: In this study, no significant independent prognostic factors could be identified that were associated to the various outcomes of recovery in service members with CLBP who followed a rehabilitation program.

scholarly journals Prognosis and Course of Disability in Patients With Chronic Nonspecific Low Back Pain: A 5- and 12-Month Follow-up Cohort Study

2013 ◽  
Vol 93 (12) ◽  
pp. 1603-1614 ◽  
Author(s):  
Karin Verkerk ◽  
Pim A.J. Luijsterburg ◽  
Martijn W. Heymans ◽  
Inge Ronchetti ◽  
Annelies L. Pool-Goudzwaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Low Back Pain ◽  
Prognostic Factors ◽  
Back Pain ◽  
Short Form ◽  
Low Back ◽  
Multidisciplinary Therapy ◽  
Patient Reported ◽  
Specific Disability

Background Few data are available on the course of and predictors for disability in patients with chronic nonspecific low back pain (CNSLBP). Objective The purpose of this study was to describe the course of disability and identify clinically important prognostic factors of low-back-pain–specific disability in patients with CNSLBP receiving multidisciplinary therapy. Design A prospective cohort study was conducted. Methods A total of 1,760 patients with CNSLBP who received multidisciplinary therapy were evaluated for their course of disability and prognostic factors at baseline and at 2-, 5-, and 12-month follow-ups. Recovery was defined as 30% reduction in low back pain–specific disability at follow-up compared with baseline and as absolute recovery if the score on the Quebec Back Pain Disability Scale (QBPDS) was ≤20 points at follow-up. Potential prognostic factors were identified using multivariable logistic regression analysis. Results Mean patient-reported disability scores on the QBPDS ranged from 51.7 (SD=15.6) at baseline to 31.7 (SD=15.2), 31.1 (SD=18.2), and 29.1 (SD=20.0) at 2, 5, and 12 months, respectively. The prognostic factors identified for recovery at 5 and 12 months were younger age and high scores on disability and on the 36-Item Short-Form Health Survey (SF-36) (Physical and Mental Component Summaries) at baseline. In addition, at 5-month follow-up, a shorter duration of complaints was a positive predictor, and having no comorbidity and less pain at baseline were additional predictors at 12-month follow-up. Limitations Missing values at 5- and 12-month follow-ups were 11.1% and 45.2%, respectively. Conclusion After multidisciplinary treatment, the course of disability in patients with CNSLBP continued to decline over a 12-month period. At 5- and 12-month follow-ups, prognostic factors were identified for a clinically relevant decrease in disability scores on the QBPDS.

Yellow flag on prognostic factors for non-specific chronic low back pain patients subjected to mini-invasive treatment: a cohort study

2020 ◽  
Vol 29 (8) ◽  
pp. 1879-1886
Author(s):  
Monica Zackova ◽  
Raffaele Aspide ◽  
Anita Braghittoni ◽  
Corrado Zenesini ◽  
Giorgio Palandri
Keyword(s):  
Cohort Study ◽  
Low Back Pain ◽  
Prognostic Factors ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Invasive Treatment ◽  
Yellow Flag ◽  
Pain Patients

scholarly journals Cognitive Functional Therapy for Disabling Nonspecific Chronic Low Back Pain: Multiple Case-Cohort Study

2015 ◽  
Vol 95 (11) ◽  
pp. 1478-1488 ◽  
Author(s):  
Kieran O'Sullivan ◽  
Wim Dankaerts ◽  
Leonard O'Sullivan ◽  
Peter B. O'Sullivan
Keyword(s):  
Cohort Study ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Functional Disability ◽  
Low Back ◽  
Functional Therapy ◽  
Baseline Phase ◽  
Multiple Case

Background Multiple dimensions across the biopsychosocial spectrum are relevant in the management of nonspecific chronic low back pain (NSCLBP). Cognitive functional therapy is a behaviorally targeted intervention that combines normalization of movement and abolition of pain behaviors with cognitive reconceptualization of the NSCLBP problem while targeting psychosocial and lifestyle barriers to recovery. Objective The purpose of this study was to examine the effectiveness of cognitive functional therapy for people with disabling NSCLBP who were awaiting an appointment with a specialist medical consultant. Design A multiple case-cohort study (n=26) consisting of 3 phases (A1–B–A2) was conducted. Methods Measurement phase A1 was a baseline phase during which measurements of pain and functional disability were collected on 3 occasions over 3 months for all participants. During phase B, participants entered a cognitive functional therapy intervention program involving approximately 8 treatments over an average of 12 weeks. Finally, phase A2 was a 12-month, no-treatment follow-up period. Outcomes were analyzed using repeated-measures analysis of variance or Friedman test (with post hoc Bonferroni correction) across 7 time intervals, depending on normality of data distribution. Results Statistically significant reductions in both functional disability and pain were observed immediately postintervention and were maintained over the 12-month follow-up period. These reductions reached clinical significance for both disability and pain. Secondary psychosocial outcomes, including depression, anxiety, back beliefs, fear of physical activity, catastrophizing, and self-efficacy, were significantly improved after the intervention. Limitations The study was not a randomized controlled trial. Although primary outcome data were self-reported, the assessor was not blinded. Conclusions These promising results suggest that cognitive functional therapy should be compared with other conservative interventions for the management of disabling NSCLBP in secondary care settings in large randomized clinical trials.

scholarly journals A Novel Placement Technique of S2 Screw (from S2 to Promontorium) and Double Screwing from S2

2021 ◽  
Author(s):  
Sedat Dalbayrak ◽  
Ahmet Öğrenci ◽  
Ezgi Akar ◽  
Orkun Koban ◽  
Mesut Yılmaz
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Revision Surgery ◽  
Chronic Low Back Pain ◽  
Screw Placement ◽  
Low Back ◽  
Screw Loosening ◽  
Dynamic Instrumentation ◽  
Placement Technique

AbstractSince pseudoarthrosis or screw loosening is frequently seen in lumbosacral stabilizations ending in S1, S2 screws are used more frequently to support S1 screws. This study aims to describe a new screw placement technique and location from S2. Revision surgery was applied to the patient who had previously undergone surgery with the rigid instrumentation system and encountered pseudoarthrosis during the follow-up period. Instrumentation was performed from S2 to the promontorium. The patient’s chronic low back pain arising due to pseudoarthrosis was reduced and a strong lumbosacral dynamic instrumentation was performed to the patient. Dual screw placement from S2 and/or screw placement in the S2-promontorium direction is a new alternative to provide a powerful instrumentation.

scholarly journals Prognosis and course of work-participation in patients with chronic non-specific low back pain: A 12-month follow-up cohort study

2015 ◽  
Vol 47 (9) ◽  
pp. 854-859 ◽  
Author(s):  
K Verkerk ◽  
P Luijsterburg ◽  
A Pool-Goudzwaard ◽  
M Heymans ◽  
I Ronchetti ◽  
...  
Keyword(s):  
Cohort Study ◽  
Low Back Pain ◽  
Back Pain ◽  
Work Participation ◽  
Low Back

scholarly journals A Prospective Randomized Controlled Study of Auricular Point Acupressure to Manage Chronic Low Back Pain in Older Adults: Study Protocol

2019 ◽  
Author(s):  
Chao Hsing Yeh ◽  
Cuicui Li ◽  
Ronald Glick ◽  
Elizabeth A. Schlenk ◽  
Kathryn Albers ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Comparison Group ◽  
Controlled Study ◽  
Low Back ◽  
Randomized Controlled ◽  
Auricular Point

Abstract Background: Chronic low back pain (cLBP) is a major health problem and the most common pain condition among those 60 years of age or older in the US. Despite the development of pharmacological and nonpharmacological interventions, cLBP outcomes have not improved and disability rates continue to rise. This study aims to test auricular point acupressure (APA) as a non-invasive, nonpharmacological self-management strategy to manage cLBP and to address current shortcomings of cLBP treatment. Methods: For this prospective randomized controlled study, participants will be randomly assigned into three groups: (1) APA (active points related to cLBP), (2) Comparison Group -1 (non-active points, unrelated to cLBP), (3) Comparison Group-2 (enhanced educational control, an educational booklet on cLBP will be given and the treatment used by participants for their cLBP will be recorded). The ecological momentary assessment smartphone app will be used to collect real-time cLBP outcomes and adherence to APA practice. Treatment and nonspecific psychological placebo effects will be measured via questionnaires for all participants. This proposed trial will evaluate the APA sustained effects for cLBP at 12-month follow-up. Monthly phone follow-up will be used to collect study outcomes. Blood will be collected during study visits at baseline, post-APA treatment, and follow-up study visits at 1-, 3-, 6-, 9- and 12-months post-completion of treatment for a total of 7 assessments. Appointments will start between 9 and 11 am to control for circadian variation in cytokine levels. Discussion: This study is expected to provide vital information on the efficacy, sustainability, and underlying mechanism of APA on cLBP necessary for APA to gain acceptance from both healthcare providers and patients, which would provide a strong impetus for including APA as part of cLBP management in clinical and home settings. Trial registration: NCT03589703, Registered on May 22, 2018 Keywords: Chronic low back pain, auricular point acupressure, older adults, cytokines

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