Prognostic factors for perceived recovery or functional improvement in non-specific low back pain: secondary analyses of three randomized clinical trials

Helmhout, Pieter H.; Staal, J. Bart; Heymans, Martijn W.; Harts, Chris C.; Hendriks, Erik J. M.; de Bie, Rob A.

doi:10.1007/s00586-009-1254-8

Cited by 71Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationSpine and Intervertebral Disc Pathology

Prognostic factors for perceived recovery or functional improvement in non-specific low back pain: secondary analyses of three randomized clinical trials

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Helmhout, Pieter H., Staal, J. Bart, Heymans, Martijn W., Harts, Chris C., Hendriks, Erik J. M., de Bie, Rob A.·2010·European Spine Journal

DOI 10.1007/s00586-009-1254-8PMC PMC2899835

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Abstract

The objective of this study was to report on secondary analyses of a merged trial dataset aimed at exploring the potential importance of patient factors associated with clinically relevant improvements in non-acute, non-specific low back pain (LBP). From 273 predominantly male army workers (mean age 39 +/- 10.5 years, range 20-56 years, 4 women) with LBP who were recruited in three randomized clinical trials, baseline individual patient factors, pain-related factors, work-related psychosocial factors, and psychological factors were evaluated as potential prognostic variables in a short-term (post-treatment) and a long-term logistic regression model (6 months after treatment). We found one dominant prognostic factor for improvement directly after treatment as well as 6 months later: baseline functional disability, expressed in Roland-Morris Disability Questionnaire scores. Baseline fear of movement, expressed in Tampa Scale for Kinesiophobia scores, had also significant prognostic value for long-term improvement. Less strongly associated with the outcome, but also included in our final models, were supervisor social support and duration of complaints (short-term model), and co-worker social support and pain radiation (long-term model). Information about initial levels of functional disability and fear-avoidance behaviour can be of value in the treatment of patient populations with characteristics comparable to the current army study population (e.g., predominantly male, physically active, working, moderate but chronic back problems). Individuals at risk for poor long-term LBP recovery, i.e., individuals with high initial level of disability and prominent fear-avoidance behaviour, can be distinguished that may need additional cognitive-behavioural treatment.

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Musculoskeletal pain, rheumatoid arthritis, gastrointestinal, neuropathic, facial pain, and headache are all more prevalent in females than males.
“musculoskeletal pain, rheumatoid arthritis, gastrointestinal, neuropathic, facial pain and headache are all more prevalent among females compared to males 156–160.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [157]

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Prognostic factors for perceived recovery or functional improvement in non-specific low back pain: secondary analyses of three randomized clinical trials. Helmhout PH, Staal JB, Heymans MW, Harts CC, Hendriks EJ, de Bie RA. Eur Spine J 2009 Dec 25. (Epub ahead of print)
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Authors: Helmhout, P. H., Staal, J. B., Heymans, M. W., Harts, C. C., Hendriks, E. J. M., & de Bie, R. A.
Affiliations: Maastricht University (NL)
Vrije Universiteit Amsterdam (NL)
Corresponding author: Helmhout, Pieter H.
ORCID: Helmhout, Pieter H.
Staal, J. Bart
Heymans, Martijn W.
Venue: European Spine Journal
Publisher: Springer Science and Business Media LLC
Published: 2009-12-25
Volume: 19
Issue: 4
Pages: 650-659
ISSN: 0940-6719 (ISSN-L)
1432-0932
DOI: 10.1007/s00586-009-1254-8
PMC: PMC2899835
OpenAlex: W2116353772
Cited by: 71
References: 69
Citations by year: 2025: 3 · 2024: 7 · 2023: 3 · 2022: 6 · 2021: 5 · 2020: 7 · 2019: 2 · 2018: 3 · 2017: 1 · 2016: 4 · 2015: 4 · 2014: 3 · 2013: 4 · 2012: 5
FWCI: 4.57
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
Locations: European Spine Journal (publishedVersion, cc-by-nc)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
Research Publications (Maastricht University) (publishedVersion, cc-by-nc)
Pure Amsterdam UMC (publishedVersion, other-oa)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
VU Research Portal (submittedVersion, other-oa)
Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
Radboud Repository (Radboud University) (submittedVersion)
Research Publications (Maastricht University) (submittedVersion, cc-by-nc)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Keywords: non-specific low back pain, prognostic factors, functional recovery, functional disability, fear-avoidance beliefs, kinesiophobia, social support, radiating pain, cognitive-behavioral intervention, long-term outcomes
MeSH terms: Activities of Daily Living, Adult, Female, Humans, Male, Middle Aged, Pain Measurement, Prognosis, Prospective Studies, Surveys and Questionnaires, Regression Analysis, Severity of Illness Index, Low Back Pain, Recovery of Function

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Prognostic factors for perceived recovery or functional improvement in non-specific low back pain: secondary analyses of three randomized clinical trials

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