Prognostic factors and course for successful clinical outcome quality of life and patients' perceived effect after a cognitive behavior therapy for chronic non-specific low back pain: A 12-months prospective study

Man Ther. 2015 Feb;20(1):96-102. doi: 10.1016/j.math.2014.07.003. Epub 2014 Jul 25.


This study investigates the clinical course of and prognostic factors for quality of life (Short Form 36 items Health survey (SF-36)) and global perceived effect (GPE) in patients treated for chronic non-specific low back pain at 5 and 12-months follow-up. Data from a prospective cohort (n = 1760) of a rehabilitation center were used, where patients followed a 2-months cognitive behavior treatment. The outcome 'improvement in quality of life (SF-36)' was defined as a 10% increase in score on the SF-36 at follow-up compared with baseline. On the GPE scale, patients who indicated to be 'much improved' were coded as 'clinically improved'. Multivariable logistic regression analysis included 23 baseline characteristics. At 5-months follow-up, scores on the SF-36 Mental Component Scale (SF-36; MCS) and the Physical Component Scale (SF-36; PCS) had increased from 46.6 (SD 10.3) to 50.4 (SD 9.8) and from 31.9 (SD 7.1) to 46.6 (SD 10.3), respectively. At 5-months follow-up, 53.0% of the patients reported clinical improvement (GPE) which increased to 60.3% at 12-months follow-up. The 10% improvement in quality of life (SF-36 MCS) at 5-months follow-up was associated with patient characteristics and psychological factors. At 5-months follow-up, the 10% improvement in quality of life (SF-36 PCS) and GPE was associated with patient characteristics, physical examination, work-related factors and psychological factors; for GPE, an association was also found with clinical status. At 12-months follow-up GPE was associated with patient characteristics, clinical status, physical examination and work-related factors. The next phase in this prognostic research is external validation of these results.

Keywords: Chronic non-specific low back pain; Course; Prognosis; Psychological factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease
  • Cognitive Behavioral Therapy*
  • Disability Evaluation
  • Female
  • Humans
  • Low Back Pain / psychology*
  • Male
  • Pain Measurement
  • Prospective Studies
  • Quality of Life*
  • Treatment Outcome