Illness perceptions as an independent predictor of chronic low back pain and pain-related disability: a prospective cohort study

Hallegraeff, Joannes M; Trijffel, Emiel van; Kan, Ronald; Stenneberg, Martijn S.; Reneman, Michiel F.

doi:10.1016/j.physio.2020.12.001

Cited by 8 publications

(9 citation statements)

References 18 publications

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“… 28 29 Similar to our findings, a prospective cohort study (2020) of people with acute LBP found that maladaptive illness perceptions measured by IPQ were predictive of pain but not disability at 12 weeks although the predictive value was low. 30 The same trend was seen for musculoskeletal pain, where IPQ did not add substantially to the prediction of recovery. 10 Similarly, a secondary analysis of a randomised controlled trial published in 2018 showed that high levels of fear-avoidance beliefs measured by the Fear-Avoidance Beliefs Questionnaire in patients with LBP were only weakly associated with worse outcomes in LBP and disability at 12 months, yet the association was much stronger for sick leave.…”

Section: Discussionmentioning

confidence: 69%

Beliefs about back pain and associations with clinical outcomes: a primary care cohort study

2022

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ObjectiveTo investigate associations between beliefs about low back pain (LBP) at baseline and pain intensity and disability at 2-week, 13-week and 52-week follow-up.DesignObservational cohort study.SettingPrimary care private chiropractic clinics in Denmark.ParticipantsA total of 2734 adults consulting a chiropractor for a new episode of LBP, with follow-up data available from 71%, 61% and 52% of the participants at 2, 13 and 52 weeks, respectively.Outcome measuresBeliefs about LBP were measured by the Back Belief Questionnaire (BBQ) before consulting the chiropractor. Pain (Numerical Rating Scale 0–10) and disability (the Roland-Morris Disability Questionnaire) were measured at baseline and after 2, 13 and 52 weeks. Associations were explored using longitudinal linear mixed models estimating interactions between BBQ and time, and by estimating associations between single items of BBQ and 13-week outcomes.ResultsMore positive beliefs about LBP were weakly associated with a reduction in pain at 2 weeks (β interaction BBQ#Time=−0.02 (95% CI −0.04 to −0.001)), at 13 weeks (−0.03 (95% CI −0.05 to −0.01)) and at 52 weeks of follow-up (−0.03 (95% CI −0.05 to −0.01); p=0.003). For disability, the association was uncertain (p=0.7). The item ‘Back trouble means periods of pain for the rest of one’s life’ had the strongest association with both reduction in pain (−0.29, 95% CI −0.4 to −0.19, p<0.001) and disability (−2.42, 95% CI −3.52 to −1.33, p<0.001) at 13-week follow-up.ConclusionPositive beliefs regarding LBP, measured by the BBQ, were associated with a reduction in pain intensity at both short-term and long-term follow-up. However, the association was weak, and the clinical relevance is therefore questionable. No clear association was demonstrated between beliefs and disability. This study did not show promise that back beliefs as measured by the BBQ were helpful for predicting or explaining the course of LBP in this setting.

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Section: Discussionmentioning

confidence: 69%

Beliefs about back pain and associations with clinical outcomes: a primary care cohort study

2022

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“…There are significant impacts of the COVID-19 pandemic and lockdown measures on psychological wellbeing including anxiety and depression, [ 22 , 23 ] and psychological wellbeing is known to influence patients' quality of life and perceptions of their pain and function [ 24 – 26 ]. However, despite this, our study has shown no overall differences in ODI scores between patients during lockdown and those taken from patients before lockdown.…”

Section: Discussionmentioning

confidence: 99%

The effect of COVID-19 lockdown restrictions on oswestry disability index scores: a comparative cross-sectional study

et al. 2022

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Purpose Lockdown measures to combat the COVID-19 pandemic restricted social interactions and travel. This retrospective, observational study was conducted to evaluate the effect of lockdown restrictions on Oswestry Disability Index (ODI) scores in patients with spinal conditions. Methods Prospectively collected data from the British Spine Registry were retrospectively analysed in two groups. The study group included patients' baseline pre-operative ODI scores collected during the first national lockdown in the UK between March and May 2020. The reference group included ODI scores recorded during the same period in 2019, before the pandemic. Scores were compared between groups using the Mann–Whitney U test. We also calculated modified scores that omitted responses to questions related to travel and social life. These were compared using Wilcoxon matched-pairs signed-rank test and Bland–Altman analyses. Results The median ODI scores for the reference and lockdown groups were 49 and 45, respectively, with no significant differences in the mean ranks ( p = 0.068). Comparisons of original and modified ODI scores showed different outcomes for each study group. No significant differences were observed in the lockdown group ( p = 0.06). However, for the pre-COVID-19 reference group, there was a significant difference ( p < 0.01). Bland–Altman analyses showed reasonable agreement between the methods for calculating ODI in both groups. Conclusion We found no clinically important differences in ODI scores between the two groups. The findings suggest that the ODI is reliable during lockdown situations and can be used with confidence in the future research using both retrospective and prospective data. Level of evidence Level 3.

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“…The variables of sleep quality, depression, anxiety, stress, disability and pain intensity were dichotomized for the purposes of the analysis and achievement of appropriate convergence in negative binomial regression models. The cut-offs for dichotomization were based on previous studies for each variable: sleep quality ≥6 (Buysse et al, 1989), depression ≤9 (Henry & Crawford, 2005), anxiety ≤7 (Henry & Crawford, 2005), stress ≤14 (Henry & Crawford, 2005), disability ≤5 (Kuijer et al, 2005) and pain intensity ≥3 (Hallegraeff et al, 2021). Each model was adjusted for covariates (age, BMI, pain intensity, stress, sleep quality and history of pain) that were found to be significantly associated (p < 0.1) with both predictors and outcomes in univariate models.…”

Section: Discussionmentioning

confidence: 99%

The impact of different intensities and domains of physical activity on analgesic use and activity limitation in people with low back pain: A prospective cohort study with a one‐year followup

Patterson

Beckenkamp

Ferreira

et al. 2022

European Journal of Pain

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Background: Analgesics are the most common form of managing low back pain (LBP). No previous study has examined which domains and intensities of physical activity are most beneficial in reducing the frequency of analgesic use for LBP and its related activity limitation.Methods: This cohort study forms part of the AUstralian Twin low BACK pain study, investigating the impact of physical activity on LBP. Information on demographics, LBP and health-related factors, including physical activity, were collected at baseline. Data on the total counts of analgesic use and activity limitation for LBP were collected weekly for one-year. Negative binomial regression models were conducted separately for each type of physical activity. Results were presented as incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Results:From an initial sample of 366 participants, 86 participants reported counts of analgesic use and 140 recorded counts of activity limitation across the follow-up period. The negative binomial regression models for analgesic use counts indicated that engagement in moderate-vigorous physical activity was protective for use of analgesics (IRR 0.97, 95% CI 0.96-0.99), while physical workload was associated with greater use (IRR 1.02, 95% CI 1.01-1.05). No other significant relationships were observed for the other measures of physical activity. For activity limitation counts, engagement in leisure activity was associated with less counts of activity limitation (IRR 0.94, 95% CI 0.81-0.99), while greater amounts of sedentary time was associated with higher counts (IRR 1.04, 95% CI 1.01-1.09). No other significant relationships were observed for the other measures of physical activity. Conclusions:Our findings highlight the potential importance of supporting engagement in moderate-vigorous and leisure physical activity as well as minimizing sedentary time and physical workload to reduce the risk of activity limitation and the need for analgesic use in people with LBP.

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Illness perceptions as an independent predictor of chronic low back pain and pain-related disability: a prospective cohort study

Cited by 8 publications

References 18 publications

Beliefs about back pain and associations with clinical outcomes: a primary care cohort study

Beliefs about back pain and associations with clinical outcomes: a primary care cohort study

The effect of COVID-19 lockdown restrictions on oswestry disability index scores: a comparative cross-sectional study

The impact of different intensities and domains of physical activity on analgesic use and activity limitation in people with low back pain: A prospective cohort study with a one‐year followup

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