Cohort profile: why do people keep hurting their back?
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BMC Research Notes Open Access
RESEARCH NOTE
Cohort profile: why do people keep hurting their back? David M. Klyne1 , Wolbert van den Hoorn1 , Mary F. Barbe2 , Jacek Cholewicki3 , Leanne M. Hall1 , Asaduzzaman Khan4 , Roberto Meroni5 , G. Lorimer Moseley6 , Michael Nicholas7 , Lee O’Sullivan1 , Rachel Park1 , Glen Russell1 , Michele Sterling8,9 and Paul W. Hodges1*
Abstract Objective: Low back pain (LBP) is one of the most disabling and costly conditions worldwide. It remains unclear why many individuals experience persistent and recurrent symptoms after an acute episode whereas others do not. A longitudinal cohort study was established to address this problem. We aimed to; (1) evaluate whether promising and potentially modifiable biological, psychological, social and behavioural factors, along with their possible interactions, predict LBP outcome after an acute episode; (2) compare these factors between individuals with and without acute LBP; and (3) evaluate the time-course of changes in these factors from LBP onset. This paper outlines the methodology and compares baseline characteristics between acute LBP and control, and LBP participants with and without follow-up. Results: 133 individuals with acute LBP and 74 pain-free individuals participated. Bio-psycho-social and behavioural measures were collected at baseline and 3-monthly for 12 months (LBP) or 3 months (control). Pain and disability were recorded fortnightly. Baseline characteristics were mostly similar between those who did and did not return for follow-up. Initial analyses of this cohort have revealed important insights into the pathways involved in acute-tochronic LBP. These and future findings will provide new targets for treatment and prevention of persistent and recurrent LBP. Keywords: Low back pain (LBP), Acute to chronic, Biological factors, Psychological factors, Social factors, Behavioural factors Introduction Low back pain (LBP) is the world’s leading cause of disability [1] and is associated with enormous and escalating costs to society [2]. Most of this burden is attributed to the condition when LBP becomes persistent or recurrent. Why some individuals with acute LBP recover, whereas others do not [3, 4], is largely unknown.
*Correspondence: [email protected] 1 NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD 4072, Australia Full list of author information is available at the end of the article
Although psychosocial factors have generally been considered stronger predictors of long-term outcome than diagnostic or injury-related factors [5, 6], they only explain a small proportion of the variance in outcome [6, 7]. Biological factors have largely been dismissed and the few that have been comprehensively addressed (e.g., muscle strength/endurance [8]) have little relation to outcome [9]. With this incomplete understanding of factors related to LBP outcome, it is not surprising that most treatments ha
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