Predictors for future activity limitation in women with chronic low back pain consulting primary care: a 2-year prospective longitudinal cohort study

Nordeman, Lena; Thorselius, Lena; Gunnarsson, Ronny; Mannerkorpi, Kaisa

doi:10.1136/bmjopen-2016-013974

Cited by 17 publications

(23 citation statements)

References 53 publications

(42 reference statements)

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“…However, in this study stress was not differentiated further. 16 A major psychological construct influencing an indivi-dual´s management of both stress and pain is self-efficacy. [17][18][19] It is defined as a person´s belief to be able to deal with upcoming challenges.…”

Section: Introductionmentioning

confidence: 99%

<p>Stress and Self-Efficacy as Long-Term Predictors for Chronic Low Back Pain: A Prospective Longitudinal Study</p>

Puschmann¹,

Drießlein²,

Beck³

et al. 2020

JPR

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Purpose: Psychosocial variables are known risk factors for the development and chronification of low back pain (LBP). Psychosocial stress is one of these risk factors. Therefore, this study aims to identify the most important types of stress predicting LBP. Self-efficacy was included as a potential protective factor related to both, stress and pain. Participants and Methods: This prospective observational study assessed n = 1071 subjects with low back pain over 2 years. Psychosocial stress was evaluated in a broad manner using instruments assessing perceived stress, stress experiences in work and social contexts, vital exhaustion and life-event stress. Further, self-efficacy and pain (characteristic pain intensity and disability) were assessed. Using least absolute shrinkage selection operator regression, important predictors of characteristic pain intensity and pain-related disability at 1-year and 2-years follow-up were analyzed. Results: The final sample for the statistic procedure consisted of 588 subjects (age: 39.2 (±13.4) years; baseline pain intensity: 27.8 (±18.4); disability: 14.3 (±17.9)). In the 1-year follow-up, the stress types "tendency to worry", "social isolation", "work discontent" as well as vital exhaustion and negative life events were identified as risk factors for both pain intensity and pain-related disability. Within the 2-years follow-up, Lasso models identified the stress types "tendency to worry", "social isolation", "social conflicts", and "perceived long-term stress" as potential risk factors for both pain intensity and disability. Furthermore, "self-efficacy" ("internality", "self-concept") and "social externality" play a role in reducing pain-related disability. Conclusion: Stress experiences in social and work-related contexts were identified as important risk factors for LBP 1 or 2 years in the future, even in subjects with low initial pain levels. Self-efficacy turned out to be a protective factor for pain development, especially in the long-term follow-up. Results suggest a differentiation of stress types in addressing psychosocial factors in research, prevention and therapy approaches.

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Section: Introductionmentioning

confidence: 99%

<p>Stress and Self-Efficacy as Long-Term Predictors for Chronic Low Back Pain: A Prospective Longitudinal Study</p>

Puschmann¹,

Drießlein²,

Beck³

et al. 2020

JPR

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“…Findings of these two reviews are therefore limited in generalizability to these LBP subgroups. Moreover, many primary studies have been published in this area since 2014 [37][38][39][40][41][42][43][44][45][46][47], particularly around disability, medication use, and surgical outcomes. A comprehensive and up-todate systematic review is needed to inform future research and practice, and improve health services delivery and quality of care for LBP.…”

Section: Introductionmentioning

confidence: 99%

The association between depressive symptoms or depression and health outcomes in adults with low back pain with or without radiculopathy: protocol of a systematic review

et al. 2019

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Background: A considerable proportion of adults with low back pain (LBP) suffer from depressive symptoms or depression. Those with depressive symptoms or depression may be at risk of poorer LBP recovery and require more health care. Understanding the role of prognostic factors for LBP is critically important to guide management and health services delivery. Our objective is to conduct a systematic review to assess the association between depressive symptoms or depression and health outcomes in adults with LBP with or without radiculopathy. Methods: Electronic databases including MEDLINE, Embase, CINAHL, and PsycINFO will be searched from inception to April 2019 to identify relevant studies. Additional citations will be identified by searching reference lists of included studies and related systematic reviews. Cohort and case-control studies assessing the association between depressive symptoms/ depression and health outcomes in adults aged 16 years and older with LBP with or without radiculopathy will be included. The following will be included: depressive symptoms as measured on standardized questionnaires (e.g., Center for Epidemiologic Studies Depression Scale, Beck Depression Index), and depression as standardized diagnoses (e.g., International Classification of Diseases codes) or self-reported depression diagnosis on standardized questionnaires. Outcomes of interest are standardized measures for pain, disability, overall health status, satisfaction with care, and health care utilization. These are informed by core outcome domains that international expert panels consider important for LBP research. Pairs of reviewers will screen articles retrieved from the search, extract data, and assess risk of bias using the Risk Of Bias In Non-randomized Studies-of Exposures (ROBINS-E) tool. Reviewers will use these criteria to inform their judgment on the internal validity of studies (e.g., low, moderate, or high risk of bias). If studies are deemed homogeneous, a random effects meta-analysis on the association between depressive symptoms and health outcomes will be performed. The results of the included studies will be descriptively outlined if studies are deemed heterogeneous. Discussion: The impact of depressive symptoms and depression on health-and health care-related outcomes for LBP with or without radiculopathy will be assessed and quantified. Findings of this systematic review will advance our understanding of LBP prognosis, and guide decision-making and improve quality of care for adults with LBP. Systematic review registration: PROSPERO CRD42019130047

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“…Of these, we excluded 145 articles and the reasons for exclusions are provided in Supporting information Appendix . Finally, 12 studies (Bohman, Alfredsson, Hallqvist, Vingård, & Skillgate, ; Bousema, Verbunt, Seelen, Vlaeyen, & Knottnerus, ; Cecchi et al, ; Feitosa, Lopes, Bonfa, & Halpern, ; Hendrick et al, ; Huijnen et al, ; Hussain et al, ; Jacob, Baras, Zeev, & Epstein, ; Mortimer, Pernold, & Wiktorin, ; Nordeman, Thorselius, Gunnarsson, & Mannerkorpi, ; Pinto et al, ; Roffey et al, ) were included in this review (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…The participants of the studies were recruited from general population ( n = 3), primary care ( n = 6), secondary care ( n = 2) and tertiary care ( n = 1). Six studies (Bohman et al, ; Cecchi et al, ; Feitosa et al, ; Huijnen et al, ; Nordeman et al, ; Pinto et al, ) included patients with chronic LBP, four studies (Hussain et al, ; Jacob et al, ; Mortimer et al, ; Roffey et al, ) did not specify the duration of symptoms, one study (Bousema et al, ) included patients with subacute LBP and one study (Hendrick et al, ) included patients with acute LBP. Regarding the outcome assessment, 10 studies (Cecchi et al, ; Feitosa et al, ; Hendrick et al, ; Huijnen et al, ; Hussain et al, ; Jacob et al, ; Mortimer et al, ; Nordeman et al, ; Pinto et al, ; Roffey et al, ) assessed disability, 6 studies (Feitosa et al, ; Hussain et al, ; Jacob et al, ; Mortimer et al, ; Pinto et al, ; Roffey et al, ) assessed pain intensity and 2 studies (Bohman et al, ; Bousema et al, ) used a measure of recovery.…”

Section: Resultsmentioning

confidence: 99%

Physical activity as a prognostic factor of pain intensity and disability in patients with low back pain: A systematic review

Oliveira

Pinheiro

Teixeira

et al. 2019

European Journal of Pain

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Background and objective Identifying factors that influence the course of low back pain (LBP) is important to help clinicians to identify those patients at higher risk of non‐recovery. The objective of this systematic review was to investigate the prognostic role of physical activity in the course of LBP. Databases and data treatment Literature searches were conducted in five electronic databases from their inception to February 2018. Prospective cohort studies investigating the influence of any type of physical activity in people with LBP were considered eligible. The primary outcomes were pain intensity and disability. Two independent reviewers extracted the data and assessed the methodological quality of the included studies. Results were stratified according to participants’ symptoms duration at baseline. Results Twelve studies were considered eligible for this review. Of these, six included patients with chronic LBP, four studies did not specify the patients’ duration of symptoms, one study included patients with acute LBP, and one study included patients with subacute LBP. Included studies were heterogeneous in terms of physical activity assessment, outcomes, follow‐up duration, and statistical methods, therefore, pooling of results was not performed. We found limited evidence to support the prognostic role of physical activity in the course of LBP. Conclusions Our review identified limited evidence supporting physical activity as a prognostic factor in LBP. Future cohort studies are needed to clarify the strength and importance of this association. Significance Despite recent research in the area, this systematic review shows that there is low quality evidence that physical activity may not be a prognostic factor for predicting pain and disability in patients with LBP.

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Predictors for future activity limitation in women with chronic low back pain consulting primary care: a 2-year prospective longitudinal cohort study

Cited by 17 publications

References 53 publications

<p>Stress and Self-Efficacy as Long-Term Predictors for Chronic Low Back Pain: A Prospective Longitudinal Study</p>

<p>Stress and Self-Efficacy as Long-Term Predictors for Chronic Low Back Pain: A Prospective Longitudinal Study</p>

The association between depressive symptoms or depression and health outcomes in adults with low back pain with or without radiculopathy: protocol of a systematic review

Physical activity as a prognostic factor of pain intensity and disability in patients with low back pain: A systematic review

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