Predictors of response to exercise therapy for chronic low back pain: Result of a prospective study with one year follow-up

F. Cecchi, G. Pasquini, A. Paperini, R. Boni, C. Castagnoli, S. Pistritto, C. Macchi

Research output: Contribution to journalArticle

Abstract

Background. Low back pain (LBP) management is a critical public health issue in all developed countries. Most approaches show evidence of effects only in the short term. Aim. To identify predictors of functional outcome on discharge and at 1 year. Design. Prospective cohort study. Setting. Outpatient rehabilitation department. Population. Patients aged >18 addressed to exercise therapy for persisting LBP. Methods. The individually designed physiotherapy program provided 7 sessions (45'); patients were given advice to stay active and continue exercise program on discharge. Baseline (TO) assessment included: age, sex, time since onset, pain-related drug use, previous treatments, job, physical activity, pain (NRS) and Mental Health (SF36 sub-score); at follow-up (T2), we also enquired to on adherence to exercise prescription, physical activity, drugs. The primary outcome measure was the Roland and Morris Disability Questionnaire (RMDQ) patients scoring improvement >30% (minimal clinical important difference) were classified as respondent. Results. 211 completed follow-up (70% women; age 70.4±11.9). Average RMDQ score was reduced by 35% at T1 and by 31% at T2; NRS by 28% (Tl) and 24% (T2); 125 patients (59%) were responders on discharge; 106 (50%) at follow-up. Only higher baseline NRS predicted poor response to treatment at T1 (OR=0.83, 95% CI: 0.71-0.95, P=0.012)). At T2, older age (OR=0.94, 95% CI: 0.91-0.98, P=0.003), drug use (OR=0.18, 95% CI: 0.08-4,69, P

Original languageEnglish
Pages (from-to)143-151
Number of pages9
JournalEuropean Journal of Physical and Rehabilitation Medicine
Volume50
Issue number2
Publication statusPublished - 2014

Keywords

  • Exercise therapy -
  • Low back pain -
  • Treatment outcome

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

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