Predictors of response to physical exercise for low back pain: a secondary analysis of the ReViEEW trial
Ander Espin1, Ana Rodriguez-Larrad2, Aida Ruiz-Fernández3
1Ageing on Research Group, University of the Basque Country (UPV/EHU), Leioa, Spain; Clinical Nursing and Community Health Research Group, Biobizkaia Health Research Institute, Barakaldo, Spain.
Background:
Non-specific low back pain (nsLBP) is a prevalent and disabling condition, especially among eldercare workers. Although physical exercise is strongly recommended for nsLBP, individual responses vary considerably. Understanding the characteristics that distinguish responders from non-responders could lead to more personalized and effective interventions.
Objectives:
To identify predictors of response to physical exercise for nsLBP in eldercare workers.
Design:
Secondary analysis of the ReViEEW randomized controlled trial.
Methods:
Participants (n = 77) with baseline nsLBP intensity of ≥2 on the 0-10 numerical rating scale were included. The intervention consisted of a 12-week, twice-weekly videoconference-supervised exercise program. Responders were defined as those with ≥2-point reduction in pain post-intervention. Thirty-eight variables across eight multidimensional domains were compared between responders and non-responders using independent samples T or Mann-Whitney U tests. Variables showing between-group differences (p < 0.1) were entered into multiple logistic regression analysis.
Results:
Thirty-nine participants (51 %) were classified as responders. Of the 38 variables only three differed between groups: responders had significantly higher nsLBP intensity (p = 0.045), lower anxious symptomatology (p = 0.040), and lower hypnotic/anxiolytic medication use (p = 0.092) compared to non-responders. In the regression model, higher baseline pain intensity independently predicted favorable response (OR = 1.37; 95 % CI: 1.03-1.81), while higher anxiety predicted poorer response (OR = 0.79; 95 %CI: 0.64-0.97).
Conclusions:
Higher baseline pain intensity and lower anxiety levels were independent predictors of favorable response to physical exercise for nsLBP in eldercare workers. These findings may inform more targeted clinical decision-making and treatment selection in this population.
Trial Registration:
ClinicalTrials.gov, (NCT05050526). Registered 20 September 2021-Prospectively registered.
