Psychological Features and Their Relationship to Movement-Based Subgroups in People Living With Low Back Pain
Nicholas V Karayannis1, Gwendolen A Jull2, Michael K Nicholas3
1National Health and Medical Research Council Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia; Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA.
Objective:
To determine the distribution of higher psychological risk features within movement-based subgroups for people with low back pain (LBP).
Design:
Cross-sectional observational study.
Setting:
Participants were recruited from physiotherapy clinics and community advertisements. Measures were collected at a university outpatient-based physiotherapy clinic.
Participants:
People (N=102) seeking treatment for LBP.
Interventions:
Participants were subgrouped according to 3 classification schemes: Mechanical Diagnosis and Treatment (MDT), Treatment-Based Classification (TBC), and O'Sullivan Classification (OSC).
Main Outcome Measures:
Questionnaires were used to categorize low-, medium-, and high-risk features based on depression, anxiety, and stress (Depression, Anxiety, and Stress Scale-21 Items); fear avoidance (Fear-Avoidance Beliefs Questionnaire); catastrophizing and coping (Pain-Related Self-Symptoms Scale); and self-efficacy (Pain Self-Efficacy Questionnaire). Psychological risk profiles were compared between movement-based subgroups within each scheme.
Results:
Scores across all questionnaires revealed that most patients had low psychological risk profiles, but there were instances of higher (range, 1%-25%) risk profiles within questionnaire components. The small proportion of individuals with higher psychological risk scores were distributed between subgroups across TBC, MDT, and OSC schemes.
Conclusions:
Movement-based subgrouping alone cannot inform on individuals with higher psychological risk features.
