BACKGROUND: Recent studies on chronic low back pain (cLBP) rehabilitation suggest that predictors of treatment outcome may be differ according to the considered conservative treatment. AIM: To identify predictors of response to back school (BS), individual physiotherapy (IP) or spinal manipulation (SM) for cLBP. POPULATION: Outpatients with cLBP. SETTING: Outpatient rehabilitation department. DESIGN: Retrospective analysis from a randomized trial. METHODS: Two hundred and ten patients with cLBP were randomly assigned to either BS, IP or SM; the Roland Morris Disability Questionnaire (RM) was assessed before and after treatment: those who decreased their RM score < 2.5 were considered non-responders. Baseline potential predictors of outcome included demographics, general and cLBP history, life satisfaction. RESULTS: Of the 205 patients who completed treatment (140/205 women, age 58 +/- 14 years), non-responders were 72 (34.2%). SM showed the highest functional improvement and the lowest non-response rate. In a multivariable logistic regression, lower baseline RM score (OR 0.82, 95% CI 0.76 to 0.89, p < 0.001) and received treatment (OR 0.32, 95% CI 0.21 to 0.50, p < 0.001) were independent predictors of non-response. Being in the lowest tertile of baseline RM score (< 6) predicted non response to treatment for BS and IP, but not for SM (same risk for all tertiles). CONCLUSIONS: In our patients with cLBP lower baseline pain-related disability predicted non-response to physiotherapy, but not to spinal manipulation.

Full text (sometimes free) may be available at these link(s):      help

• PubMed
• PDF locator
• publisher