A prospective study predicting the outcome of chronic low back pain and physical therapy: the role of fear-avoidance beliefs and extraspinal pain

Aloma S A Feitosa; Jaqueline Barros Lopes; Eloisa Bonfa; Ari S R Halpern

doi:10.1016/j.rbr.2015.11.001

A prospective study predicting the outcome of chronic low back pain and physical therapy: the role of fear-avoidance beliefs and extraspinal pain

Rev Bras Reumatol. 2016 Mar 16:S0482-5004(16)00030-9. doi: 10.1016/j.rbr.2015.11.001. Online ahead of print.

[Article in English, Portuguese]

Authors

Aloma S A Feitosa¹, Jaqueline Barros Lopes¹, Eloisa Bonfa¹, Ari S R Halpern²

Affiliations

¹ Serviço de Reumatologia, Hospital das Clínicas, Universidade de São Paulo (USP), São Paulo, SP, Brasil.
² Serviço de Reumatologia, Hospital das Clínicas, Universidade de São Paulo (USP), São Paulo, SP, Brasil. Electronic address: ariradu@einstein.br.

PMID: 26995499
DOI: 10.1016/j.rbr.2015.11.001

Abstract

Objective: To identify the prognostic factors for conventional physical therapy in patients with chronic low back pain (CLBP).

Methods: Prospective observational study.

Participants: One hundred thirteen patients with CLBP selected at the Spinal Disease Outpatient Clinic.

Main outcome measures: Pain intensity was scored using the Numeric Rating Scale (NRS), and function was measured using the Roland-Morris Disability Questionnaire (RMDQ).

Results: The Fear-Avoidance Beliefs Questionnaire work subscale results (FABQ-work; odds ratio [OR]=0.27, 95% confidence interval [CI] 0.13 to 0.56, p<0.001) and extraspinal pain (OR=0.35, 95% CI 0.17 to 0.74, p=0.006) were independently associated with a decreased response to conventional physical therapy for CLBP.

Conclusion: We identified high FABQ-work and extraspinal pain scores as key determinants of a worse response to physical therapy among CLBP patients, supporting the need for a special rehabilitation program for this subgroup.

Keywords: Chronic low back pain; Crenças de evitação e medo; Dor extraespinal; Extraspinal pain; Fear‐avoidance beliefs; Lombalgia crônica; Resposta terapêutica; Therapeutic response.