TY - JOUR
T1 - Clinical courses, impact and prognostic indicators for a persistent course of low back pain
T2 - Results from a population-based cohort study
AU - Gomes, Luís Antunes
AU - Rodrigues, Ana Maria
AU - Branco, Jaime C.
AU - Canhão, Helena
AU - Cruz, Eduardo Brazete
N1 - Funding: The authors’ team wishes to acknowledge the contribution of Professor Doctor Carla Nunes for the conceptualization and formal analysis of the current study. In addition, we would like also to acknowledge the EpiDoC Unit and EpiReumaPt team for the invaluable assignment of conceptualization and operationalization of the main research project (EpiDoC), and to CHRC (UIDP/04923/2020) for supporting the current research project.
PY - 2023/3
Y1 - 2023/3
N2 - Background Low back pain (LBP) is a long-Term health condition with distinct clinical courses. Its characterization together with the identification of prognostic factors for a persistent LBP course may trigger the development of personalized interventions. This study aimed to investigate the courses of chronic LBP (CLBP), its cumulative impact, and the indicators for the persistence of pain. Material and methods Patients with active CLBP from the EpiDoC, a population-based cohort study of a randomly recruited sample of 10.661 adults with prolonged follow-up, were considered. Pain, disability, and health-related quality of life (HRQoL) were assessed at three time-points over five years. According to their pain symptoms over time, participants were classified as having a persistent (pain at the baseline and at all the subsequent time-points) or a relapsing pain course (pain at the baseline and no pain at least in one of the subsequent time-points). A mixed ANOVA was used to compare mean differences within and between patients of distinct courses. Prognostic indicators for the persistent LBP course were modulated through logistic regression. Results Among the 1.201 adults with active CLBP at baseline, 634 (52.8%) completed the three time-points of data collection: 400 (63.1%) had a persistent and 234 (36.9%) a relapsing course. Statistically significant interactions were found between the group and time on disability (F (2,1258) = 23.779, p<0.001) and HRQoL (F (2,1252) = 82.779, p<0.001). In the adjusted model, the persistent course was associated with the disability level (OR 1.86, CI95% 1.40 2.40, p<0.001), depressive symptoms (OR 1.96, CI95% 1.21 3.18, p = 0.007), female gender (OR 1.90, CI95% 1.26 2.87, p = 0.002) and having a manual job (OR 1.46, CI95% 1.02 2.10, p = 0.040). Conclusion In the long-Term, patients with CLBP may follow a persistent or relapsing course of pain. Being female, presenting depressive symptoms, having a manual job and higher disability at baseline predicts a persistent course of LBP.
AB - Background Low back pain (LBP) is a long-Term health condition with distinct clinical courses. Its characterization together with the identification of prognostic factors for a persistent LBP course may trigger the development of personalized interventions. This study aimed to investigate the courses of chronic LBP (CLBP), its cumulative impact, and the indicators for the persistence of pain. Material and methods Patients with active CLBP from the EpiDoC, a population-based cohort study of a randomly recruited sample of 10.661 adults with prolonged follow-up, were considered. Pain, disability, and health-related quality of life (HRQoL) were assessed at three time-points over five years. According to their pain symptoms over time, participants were classified as having a persistent (pain at the baseline and at all the subsequent time-points) or a relapsing pain course (pain at the baseline and no pain at least in one of the subsequent time-points). A mixed ANOVA was used to compare mean differences within and between patients of distinct courses. Prognostic indicators for the persistent LBP course were modulated through logistic regression. Results Among the 1.201 adults with active CLBP at baseline, 634 (52.8%) completed the three time-points of data collection: 400 (63.1%) had a persistent and 234 (36.9%) a relapsing course. Statistically significant interactions were found between the group and time on disability (F (2,1258) = 23.779, p<0.001) and HRQoL (F (2,1252) = 82.779, p<0.001). In the adjusted model, the persistent course was associated with the disability level (OR 1.86, CI95% 1.40 2.40, p<0.001), depressive symptoms (OR 1.96, CI95% 1.21 3.18, p = 0.007), female gender (OR 1.90, CI95% 1.26 2.87, p = 0.002) and having a manual job (OR 1.46, CI95% 1.02 2.10, p = 0.040). Conclusion In the long-Term, patients with CLBP may follow a persistent or relapsing course of pain. Being female, presenting depressive symptoms, having a manual job and higher disability at baseline predicts a persistent course of LBP.
UR - http://www.scopus.com/inward/record.url?scp=85150275384&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0265104
DO - 10.1371/journal.pone.0265104
M3 - Article
AN - SCOPUS:85150275384
SN - 1932-6203
VL - 18
JO - PLoS ONE
JF - PLoS ONE
IS - 3 March
M1 - e0265104
ER -