What is the best time point to identify patients at risk of developing persistent low back pain?
Markus Melloh1, Achim Elfering2, Anja Käser2
1Centre for Health Sciences, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland Centre for Medical Research, QEII Medical Centre, University of Western Australia, Nedlands, WA, Australia.
Background:
Early identification of patients at risk of developing persistent low back pain (LBP) is crucial.
Objective:
Aim of this study was to identify in patients with a new episode of LBP the time point at which those at risk of developing persistent LBP can be best identified.
Methods:
Prospective cohort study of 315 patients presenting to a health practitioner with a first episode of acute LBP. Primary outcome measure was functional limitation. Patients were assessed at baseline, three, six, twelve weeks and six months looking at factors of maladaptive cognition as potential predictors. Multivariate logistic regression analysis was performed for all time points.
Results:
The best time point to predict the development of persistent LBP at six months was the twelve-week follow-up (sensitivity 78%; overall predictive value 90%). Cognitions assessed at first visit to a health practitioner were not predictive.
Conclusions:
Maladaptive cognitions at twelve weeks appear to be suitable predictors for a transition from acute to persistent LBP. Already three weeks after patients present to a health practitioner with acute LBP cognitions might influence the development of persistent LBP. Therefore, cognitive-behavioral interventions should be considered as early adjuvant LBP treatment in patients at risk of developing persistent LBP.
More Related Videos
04:42Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
Published on: June 26, 2018
07:44Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis
Published on: March 23, 2019