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, and Mannerkorpi, Kaisa (2017) Predictors for future activity limitation in women with chronic low back pain consulting primary care: a 2-year prospective longitudinal cohort study. BMJ Open, 7 (6). pp. 1-11.

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Objectives: To assess if body function, activity, participation, health-related quality of life and lifestyle behavioural factors can predict activity limitation in women with chronic low back pain (CLBP) in primary healthcare (PHC) 2 years later.

Design: A 2-year prospective longitudinal cohort study within PHC.

Settings: PHC in southwestern Sweden.

Participants: The cohort comprised 130 women with CLBP attending PHC at baseline 2004-2005 and were reassessed after 2 years.

Measures: The dependent outcome variable was self-reported activity limitation (Roland Morris disability questionnaire (RMDQ)) at 2-year follow-up. Independent predictors at baseline were age, body mass index, smoking, alcohol consumption, sleep quantity and quality, leisure time physical activity, a questionnaire of clinical manifestation of stress (Stress and Crises Inventory (SCI-93)), pain localisation, pain intensity, fatigue, anxiety, depression, RMDQ, work status, private social support, health-related quality of life and measures of physical performance specified as 6 min walk test (6MWT) and hand grip strength. Relation between baseline predictors and variation in later self-reported activity limitation (RMDQ) was analysed using multivariate linear regression.

Results: Ninety-five per cent (n=123/130) were followed up after 2 years. The participants were middle-aged (mean 45 (SD 10) years), mostly educated > 9 years (88%; 108/123), mainly living with another adult (76%; 93/122) and born in Sweden (90%; 111/123). Seventy nine per cent (97/123) were categorised as having work ability at baseline. The final prognostic model including 6MWT, SCI-93 and RMDQ at baseline explained 54% of the variance in self-reported activity limitation (RMDQ) at the 2-year follow-up.

Conclusions: Lower physical performance, more severe clinical stress symptoms and more severe activity limitation predicted activity limitation after 2 years in women with CLBP within PHC. The results can give guidance for interventional trials aiming to improve physical capacity and decrease stress. The impact of the interaction between prognostic factors and interventions on activity limitation needs further investigation.

Item ID: 50520
Item Type: Article (Research - C1)
ISSN: 2044-6055
Additional Information:

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Funders: Research and Development Council of Södra Älvsborg County, Sweden
Date Deposited: 20 Sep 2017 09:50
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320216 Orthopaedics @ 10%
42 HEALTH SCIENCES > 4203 Health services and systems > 420319 Primary health care @ 90%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920204 Evaluation of Health Outcomes @ 60%
92 HEALTH > 9202 Health and Support Services > 920201 Allied Health Therapies (excl. Mental Health Services) @ 40%
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