Association between symptom duration and intensity, disability, range of motion, and modified pain perceptions amongst chronic low back pain patients

Flavell, C., Gordon, S., and Marshman, L. (2015) Association between symptom duration and intensity, disability, range of motion, and modified pain perceptions amongst chronic low back pain patients. Physiotherapy, 101 (Supplememt 1). eS390-eS390.

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Background: Chronic low back pain (CLBP) is a multi-factorial condition which remains a costly health issue. However, our understanding of the association between commonly used outcome measurements (OM) and symptom behaviour is limited for this low back pain subgroup. Previous research has reported moderate to weak correlations between symptom behaviour, range of motion (ROM), and modified pain perceptions in general low back pain populations. However, longer symptom duration and resulting psychological factors in the CLBP population support the hypothesis that different associations exist between self-reported OM and ROM than in the general population.

Purpose: To investigate the association between pain intensity on the visual analogue scale (VAS), range of motion, symptom duration (months), the Oswestry disability Index (ODI), the Roland Morris disability questionnaire (RM) and the Modified Somatic Perception Questionnaire (MSPQ) at baseline in a CLBP population.

Methods: A cross-sectional study was conducted with CLBP patients (>12weeks with or without leg pain) (n=147) recruited from a hospital CLBP clinic. Participants completed the VAS, ODI, RM and MSPQ, and a physiotherapist measured ROM of the lumbar spine using a standard tape measure protocol. Data was analysed using SPSS statistical analysis software (version 20) (SPSS inc., Chicago, IL). Independent sample analysis was conducted to assess for significant differences (p<0.05) between genders, and Pearson product-moment correlation coefficients were calculated to identify potential correlations between all baseline OM.

Results: Across all the OM, only lumbar extension ROM differed significantly between genders (u=1897, p=0.024). Correlation analysis showed that the disability OM of ODI and RM were not correlated. Weak correlations were reported between the RM and MSPQ scores (r(145) = 0.39, p<0.001), the VAS and ODI (r(145) = 0.39, p <0.001), and lumbar rotation to the right and symptom duration (r(145) = 0.18, p=0.031).

Conclusion: The assumption that increased self-reported pain intensity may be associated with limited spinal movement and elevated modified somatic pain perceptions in CLBP patients was not supported by this study. Neither did this study indicate strong associations between psychological factors and self-reported disability. Except for right rotation, symptom duration was also not associated with any ROM, pain, disability, or modified somatic pain perception measures. Pain intensity was weakly correlated with disability on the ODI, and the MSPQ was weakly correlated with the RM score, which supports similar findings in previous research. The results suggest that pain levels do not dictate patient disability status, and that strong associations between psychological factors and self-reported disability are not substantiated.

Implications: Absence of strong association between the OM highlights that clinicians should view multiple OM in the context of the patient presentation, rather than in isolation. The ODI may be a more reliable indicator of pain related functional status than the RM. Whereas the RM may be more appropriate when used in conjunction with the MSPQ.

Item ID: 42672
Item Type: Article (Abstract)
ISSN: 1873-1465
Keywords: chronic low back pain; outcome measurement; self-reported questionnaires
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Presented at WCPT 2015: World Confederation for Physical Therapy Congress, 1-4 May 2015, Singapore

Date Deposited: 30 Jun 2016 04:48
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110317 Physiotherapy @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920116 Skeletal System and Disorders (incl. Arthritis) @ 100%
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