Criteria for inclusion in programs of functional restoration for chronic low back pain: Pragmatic Study - 28/05/20
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Highlights |
• | In individuals with chronic low back pain (LBP), multimodal functional restoration programs (FRPs) have been found effective but are not always proposed. |
• | Physician referral to an FRP was found associated with long sick leave, low pain levels and low self-reported physical activity levels. |
• | The lack of association of most of the medical variables with referral to an FRP support a biopsychosocial approach in LBP. |
Abstract |
Background |
Individuals with chronic low back pain (cLBP) may benefit from multimodal functional restoration programs (FRPs).
Objective |
The aim of this study was to analyze characteristics of individuals with cLBP who were referred or not to an FRP. Because cLBP is a bio-psycho-social disorder, medical and social parameters were analysed.
Methods |
This was an observational cross-sectional study performed in 2017 in 6 tertiary centres in France. Consecutive individuals with cLBP visiting a rheumatologist or physical medicine and rehabilitation physician were included. Individuals referred or not to an FRP were compared by demographic characteristics, duration of sick leave over the past year, self-reported physical activity>1h/week, pain (numeric rating scale 0–10), anxiety/depression (Hospital Anxiety and Depression Scale), disability (Oswestry Disability Index) and kinesiophobia (Tampa Kinesiophobia Scale). Univariate and multivariate logistic regression analyses were performed, estimating odds ratios (ORs) and 95% confidence intervals (CIs).
Results |
We included 147 individuals with cLBP. The mean (SD) age was 49 (12) years and 88 (60%) were women; 58 (38%) were referred to an FRP. On multivariate analysis, referral to an FRP was associated with reduced pain level (OR: 0.95, 95% CI: 0.91–0.99, for each 1-point increase in pain score), self-reported lack 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).
Conclusion |
In this multicentric observational study, referral to an FRP was linked to pain, self-reported physical activity and sick leave but not medical characteristics assessed. These findings confirm the bio-psycho-social approach of FRPs for cLBP.
Le texte complet de cet article est disponible en PDF.Keywords : Chronic low back pain, Chronic pain, Functional restoration program, Physical activity, Public health
Plan
Vol 63 - N° 3
P. 189-194 - mai 2020 Retour au numéro
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