Prognosis and course of pain in patients with chronic non-specific low back pain: A 1-year follow-up cohort study
Prognosis and course of pain in patients with chronic non-specific low back pain: A 1-year follow-up cohort study
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DOI：
10.1002/ejp.633
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发表时间：
2015-09-01
影响因子：
3.6
通讯作者：
Koes, B. W.
中科院分区：
文献类型：
--
作者：
Verkerk, K.;Luijsterburg, P. A. J.;Koes, B. W.
背景慢性非特异性下腰痛（NSLBP）患者的恢复程度尚不清楚。本研究的目的是确定（1）慢性NSLBP在三级护理的过程中，（2）哪些因素预测5和12个月outcome.MethodsThis前瞻性研究包括1760慢性NSLBP患者从康复诊所（平均年龄40.1岁，SD 10.6）。基线测量后，患者接受2个月的多学科治疗计划;在基线后2、5和12个月进行评价。恢复定义为（1）相对恢复[与基线相比，视觉模拟评分（VAS）疼痛改善30%]和（2）绝对恢复（VAS疼痛10 mm）。多变量Logistic回归分析包括23个基线characteristics.ResultsPatient-reported强度的背痛从55.5（SD 23.0）在基线下降到37.0（SD 23.8），35.3（SD 26.1）和32.3（SD 26.9）在2，5和12个月的后续行动，分别。年龄较轻、基线时背痛、无心理/身体功能障碍（症状检查表-90，第9项）以及生活质量的身体成分量表和精神成分量表（简表-36）的基线评分较高与5个月和12个月时的恢复呈正相关。在5个月随访时，基线时较高的工作参与度也是两种恢复定义的预后因素。在12个月的随访中，有共同发病率是预测两个definition.ConclusionThe结果表明，在慢性NSLBP患者，生物心理社会预后因素可能是重要的临床医生预测恢复时，在1年期间的背痛强度。
BackgroundIt remains unclear to what extent patients recover from chronic non-specific low back pain (NSLBP). The objective of this study was to determine (1) the course of chronic NSLBP in tertiary care and (2) which factors predicted 5- and 12-month outcomes.MethodsThis prospective study includes 1760 chronic NSLBP patients from a rehabilitation clinic (mean age 40.1 years, SD 10.6). After baseline measurement, patients followed a 2-month multidisciplinary therapy programme; evaluation took place at 2, 5 and 12 months post baseline. Recovery was defined as (1) relative recovery [30% improvement on the pain, visual analogue scale (VAS) compared with baseline] and (2) absolute recovery (VAS pain10mm). The multivariate logistic regression analysis included 23 baseline characteristics.ResultsPatient-reported intensity of back pain decreased from 55.5 (SD 23.0) at baseline to 37.0 (SD 23.8), 35.3 (SD 26.1) and 32.3 (SD 26.9) at 2-, 5- and 12-month follow-up, respectively. Younger age, back pain at baseline, no psychological/physical dysfunction (Symptom Check List-90, item 9), and higher baseline scores on the physical component scale and mental component scale of quality of life (Short Form-36) were positively associated with recovery at 5 and 12 months. At 5-month follow-up, higher work participation at baseline was also a prognostic factor for both definitions of recovery. At 12-month follow-up, having co-morbidity was predictive for both definitions.ConclusionThe results of this study indicate that in chronic NSLBP patients, bio-psychosocial prognostic factors may be important for clinicians when predicting recovery in back pain intensity during a 1-year period.