Introduction: Chronic low back pain (cLBP) patients may benefit from multimodal functional restoration programs (FRPs). The aim of this study was to analyze patients' characteristics, when oriented or not towards such a program. As cLBP is a bio-psycho-social disorder medical and social parameters were analysed.
Methods:Observational cross-sectional study in six tertiary centers in France in 2017. Consecutive patients with cLBP visiting a rheumatologist or physical medicine and rehabilitation physician were included. Patients oriented or not towards a FRP were compared for demographic characteristics, duration of sick leave over the past year, self-reported physical activity >1h/week, pain, anxiety/depression (Hospital Anxiety and Depression Scale), disability (Oswestry Disease Index) and kinesiophobia (Tampa Kinesiophobia Scale). Univariate and multivariate logistic regression were performed.Results: 147 patients were analysed: mean ± standard deviation, age 48.8 ± 12.0 years, mean cLBP duration 9.1 ± 9.4 years, 88 (59.9%) women. Overall, 58 (39.5%) patients were oriented towards a FRP: these patients were younger (mean age 46.3 ± 11.2 vs 50.5 ± 12.2 years, p=0.036), had longer sick leave (mean 128.5 ± 140.6) vs 67.6 ± 107.6 days/year, p=0.004), less often self-reported physical activity (35.1% ± 48.1 vs 53.4% ± 50.2, p=0.031), and reported lower pain levels (mean 6.1 ± 2.0 vs 7.1 ± 1.9 on a 0-10 numeric scale, p=0.002) .There was no significant difference regarding functional disability, pain duration, kinesiophobia, psychological status. In multivariate analysis, lower pain (odds ratio, OR: 0.95, 95% CI [0.91;0.99] for an increase of 1 point), absence of physical activity (OR: 0.84, 95% CI [0.72;0.98]) and longer sick leave (OR: 1.03, 95 % CI [1.01;1.05] for 30 more days of sick leave) were independently associated with orientation towards a FRP.
Conclusion:Orientation towards FRPs was linked to pain, self-reported physical activity and sick leave. This confirms the biopsychosocial approach of FRPs for cLBP.