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Key factors in back disability prevention: a consensus panel on their impact and modifiability
Jaime Guzman1, Jill Hayden, Andrea D Furlan
1Institute for Work & Health, Toronto, Ontario, Canada.
Spine
|April 7, 2007
Summary
Consensus was reached on factors influencing back pain participation restrictions. Care provider reassurance, recovery expectations, and patient knowledge are key modifiable factors for prevention.
Area of Science:
- Rehabilitation Science
- Public Health
- Occupational Therapy
Background:
- Back pain significantly impacts participation and functioning, necessitating targeted prevention strategies.
- Current research often overlooks non-occupational and environmental factors contributing to back disability.
- Stakeholder consensus is crucial for guiding evidence-based prevention efforts.
Framework:
- Utilized a modified Delphi panel incorporating Q-methodology for consensus building.
- Employed a 3-round Delphi process with 33 researchers and stakeholders evaluating 32 factors.
- Defined consensus levels as strong, moderate, or low based on panel agreement.
Implementation:
- Panelists ranked factors by relative impact and modifiability using evidence summaries.
- Assessed consensus on factors affecting participation restrictions in individuals with back pain.
- Investigated disagreements on the impact of physical functioning and work-related activities.
Implications:
- Care provider reassurance emerged as a high-impact factor with strong consensus.
- Expectations of recovery and reduced fear also showed moderate consensus for high impact.
- Back supports, care provider reassurance, and patient knowledge were identified as highly modifiable.
- Future interventions should address multiple factors, prioritizing care provider reassurance.
- Further research is needed on non-occupational participation and home environmental factors.
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