Background: Central sensitization (CS) is present in a subgroup of patients with chronic low back pain (CLBP). Studies on the relationship between CS and functioning have limited operationalizations of CS and functioning.
Objective: To determine whether CS was related to functioning in patients with CLBP (cross-sectional); and to determine whether changes in CS were related to changes in functioning (longitudinal).
Methods: An observational prospective cohort study with data collected at baseline and discharge of an interdisciplinary pain rehabilitation program was executed. CS indicators: CS Inventory part A (CSI-A), quantitative sensory testing (QST), root mean square of successive differences of heart-rate variability (RMSSD). Functioning measures: lifting capacity, physical functioning subscale of Rand36 (Rand36-PF), Work Ability Score (WAS), Pain Disability Index (PDI). Main analyses included correlation and multiple regression controlling for confounders; cross-sectional with baseline data and longitudinal with deltas (ฮ).
Results: 76 patients with primary CLBP participated at baseline and 56 at discharge. Most associations were weak (cross-sectional r๐๐๐๐ก๐๐๐=-0.30-0.24; longitudinal r๐๐๐๐ก๐๐๐=-0.37-0.44). Cross-sectional multiple regression significant associations: mechanical pain threshold-QST and lifting capacity (r๐๐๐๐ก๐๐๐=-0.39), parasympathetic/vagal tone-RMSSD and physical functioning-Rand36-PF (r๐๐๐๐ก๐๐๐= 0.26). Longitudinal multiple regression significant associations: ฮ parasympathetic/vagal tone-RMSSD and ฮ lifting capacity (r๐๐๐๐ก๐๐๐= 0.48), ฮCSI-A and ฮdisability-PDI (r๐๐๐๐ก๐๐๐= 0.36). Cross-sectional and longitudinal final regression models explained 24.0%-58.3% and 13.3%-38.0% of total variance.
Conclusion: CS was weakly related to functioning, and decreases in CS were weakly-moderately related to increases in functioning.
Keywords: Hyperalgesia; disability; lifting; physical functioning; work ability.