PREDICTION OF CHRONIC DISABILITY IN SUBJECTS WITH ACUTE RECURRENT LOW BACK PAIN

Abstract

Acute recurrent LBP is prevalent within western society and is recognised as a predictor of chronic LBP related disability. Despite this, predictors of disability, in subjects with acute recurrent LBP, have not yet been explored. This study aimed to examine the association between variables of pain, psychology and disability, in acute recurrent LBP, and establish which of these measures best predicts LBP related disability.

The study was of prospective design employing regression analysis. A battery of questionnaires and a series of functional tests were obtained from 47 subjects, with acute recurrent LBP, at assessment and on conclusion of treatment. Measures of pain (VAS), psychology (CSQ, TSK, MSPQ, ZDS) and disability (step ups, stand ups, walking test, RMDQ) were employed. The criterion measure for resultant disability was the Roland Morris Disability Questionnaire.

The characteristics of the sample were found to typify that of an acute, rather than chronic, LBP population. Pain was found to correlate with all other variables and a relationship was demonstrated between subjective disability and psychological variables. The relationship between psychological variables and objective disability however, was less clear. Forty four percent of the residual disability was explained by initial scores of the Visual Analogue Pain Scale, the Modified Somatic Perceptions Questionnaire and the Roland Morris Disability Questionnaire. Fifty six percent of the resultant disability remains unexplained by the variables explored in this study.

It was concluded that subjects at risk of chronic LBP related disability might be identified at assessment by the initial levels of , anxiety and subjective disability.