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The smallest worthwhile change on function from a self-management intervention for non-persistent low back pain.

Carolina Gassen Fritsch1, Paulo H Ferreira2, Thomas Lung3

  • 1Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Level 10, Kolling Building, Royal North Shore Hospital, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia. carolina.gassenfritsch@sydney.edu.au.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|June 14, 2023
PubMed
Summary

Patients with low back pain (LBP) consider a 9.4-point functional improvement worthwhile from self-management interventions. Those with lower baseline function require greater improvements for perceived value.

Keywords:
FunctionLow back painSelf-managementSufficiently important difference

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Area of Science:

  • Health Services Research
  • Rehabilitation Medicine
  • Patient-Reported Outcomes

Background:

  • Low back pain (LBP) is a prevalent condition impacting function and quality of life.
  • Self-management interventions are crucial for managing chronic LBP.
  • Understanding patient-perceived value is essential for intervention effectiveness.

Purpose of the Study:

  • To determine the minimal clinically important difference in function for LBP patients undergoing self-management.
  • To identify patient-related factors associated with this minimal worthwhile change.

Main Methods:

  • Cross-sectional analysis of 212 participants from the TEXT4myBACK trial.
  • Patients reported the smallest functional improvement (0-30 scale) to deem an intervention worthwhile.
  • Multivariate regression analyzed associations between patient factors and the smallest worthwhile change.

Main Results:

  • On average, a 9.4-point (SD: 5.7) improvement in function was considered worthwhile.
  • Lower baseline function was significantly associated with needing greater improvements (β = -0.60).

Conclusions:

  • An average improvement of 9.4 points (31%) in function is the threshold for LBP self-management interventions to be perceived as worthwhile.
  • Patients with more severe functional limitations require larger improvements to consider interventions valuable.