Related Experiment Video
Updated: May 22, 2026
Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
Predictors of functional outcome in patients with chronic low back pain undergoing back school, individual
F Cecchi1, S Negrini, G Pasquini
1Fondazione Don Carlo Gnocchi, Scientific Institute, Outpatient Rehabilitation Department, Florence, Italy. francescacecchi2002@libero.it
Background:
Recent studies on chronic low back pain (cLBP) rehabilitation suggest that predictors of treatment outcome may be differ according to the considered conservative treatment.
Aim:
To identify predictors of response to back school (BS), individual physiotherapy (IP) or spinal manipulation (SM) for cLBP.
Population:
outpatients with cLBP.
Setting:
Outpatient rehabilitation department.
Design:
Retrospective analysis from a randomized trial.
Methods:
Two hundred and ten patients with cLBP were randomly assigned to either BS, IP or SM; the Roland Morris Disability Questionnaire (RM) was assessed before and after treatment: those who decreased their RM score <2.5 were considered non-responders. Baseline potential predictors of outcome included demographics, general and cLBP history, life satisfaction.
Results:
Of the 205 patients who completed treatment (140/205 women, age 58+14 years), non-responders were 72 (34.2%). SM showed the highest functional improvement and the lowest non-response rate. In a multivariable logistic regression, lower baseline RM score (OR 0.82, 95% CI 0.76-0.89, P<0.001) and received treatment (OR 0.32, 95% CI 0.21-0.50, P<0.001) were independent predictors of non-response. Being in the lowest tertile of baseline RM score (<6) predicted non response to treatment for BS and IP, but not for SM (same risk for all tertiles).
Conclusions:
In our patients with cLBP lower baseline pain-related disability predicted non-response to physiotherapy, but not to spinal manipulation.
Clinical Rehabilitation Impact:
Our results suggest that, independent form other characteristics, patients with cLBP and low pain-related disability should first consider spinal manipulation as a conservative treatment.
