Article

Few data are available on the course of and predictors for disability
in patients with chronic nonspecific low back pain (CNSLBP). The
purpose of this study was to describe the course of disability and identify
clinically important prognostic factors of low-back-pain-specific disability in
patients with CNSLBP receiving multidisciplinary therapy. DESIGN: A prospective
cohort study was conducted. METHODS: A total of 1,760 patients with CNSLBP who
received multidisciplinary therapy were evaluated for their course of disability
and prognostic factors at baseline and at 2-, 5-, and 12-month follow-ups.
Recovery was defined as 30% reduction in low back pain-specific disability at
follow-up compared with baseline and as absolute recovery if the score on the
Quebec Back Pain Disability Scale (QBPDS) was </=20 points at follow-up.
Potential prognostic factors were identified using multivariable logistic
regression analysis. RESULTS: Mean patient-reported disability scores on the
QBPDS ranged from 51.7 (SD=15.6) at baseline to 31.7 (SD=15.2), 31.1 (SD=18.2),
and 29.1 (SD=20.0) at 2, 5, and 12 months, respectively. The prognostic factors
identified for recovery at 5 and 12 months were younger age and high scores on
disability and on the 36-Item Short-Form Health Survey (SF-36) (Physical and
Mental Component Summaries) at baseline. In addition, at 5-month follow-up, a
shorter duration of complaints was a positive predictor, and having no
comorbidity and less pain at baseline were additional predictors at 12-month
follow-up. LIMITATIONS: Missing values at 5- and 12-month follow-ups were 11.1%
and 45.2%, respectively. CONCLUSION: After multidisciplinary treatment, the
course of disability in patients with CNSLBP continued to decline over a 12-month
period. At 5- and 12-month follow-ups, prognostic factors were identified for a
clinically relevant decrease in disability scores on the QBPDS.

Langue : ANGLAIS