Task-Specific Sensitivity in Physical Function Testing Predicts Outcome in Patients With Low Back Pain

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  • Nûno Trolle, Danish Ramazzini Centre, Hospital Unit Regional Hospital West Jutland, Department of Occupational Medicine - University Research Clinic, Herning, Denmark.
  • ,
  • Thomas Maribo
  • Lone Donbæk Jensen
  • ,
  • David Høyrup Christiansen

STUDY DESIGN: Prospective cohort study nested in a randomized controlled trial.

BACKGROUND: Low back pain (LBP) is the leading cause of pain and disability globally. Few prognostic factors are consistently reported to predict outcome in patients with LBP and findings from clinical examination and physical task performance levels (e.g. walking distance) lack prognostic value. However, recent findings suggest measuring patients' pain sensitivity to task performance tests (task-specific sensitivity) may be of predictive value.

OBJECTIVE: To investigate the prognostic value of task-specific sensitivity in patients with LBP by exploring whether task-specific sensitivity during physical function testing is associated with self-reported change in pain and disability.

METHODS: The study included 260 patients with LBP, referred for evaluation in secondary care setting. All patients completed questionnaires and underwent clinical examination by a physiotherapist. Patients rated their pain intensity before and after completing a test battery measuring physical function and were classified into four categories; worse, unchanged, better or no pain, depending on their pain response. At 3-month follow-up, outcomes were obtained by a postal questionnaire.

RESULTS: Task-specific sensitivity significantly predicted pain, when adjusting for known prognostic factors. Patients classified as no pain, better and unchanged improved significantly more in pain score compared to patients classified as worse. Patients classified as no pain also improved significantly more in disability score compared to patients classified as worse after adjusting for known prognostic factors.

CONCLUSION: Measuring task-specific sensitivity is predictive of pain intensity after 3 months in patients with LBP. The prognostic value appears limited in respect to disability.

LEVEL OF EVIDENCE: Prognosis, level 1b. J Orthop Sports Phys Ther, Epub 30 Oct 2019. doi:10.2519/jospt.2020.8953.

OriginalsprogEngelsk
TidsskriftJournal of Orthopaedic and Sports Physical Therapy
Vol/bind50
Nummer4
Sider (fra-til)170-217
Antal sider47
ISSN0190-6011
DOI
StatusUdgivet - apr. 2020

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