Demographic and clinical characteristics associated with failure of physical therapy in chronic low back pain: a secondary analysis from a randomized controlled trial

被引:1
作者
Zhang, Yong-Hui [1 ,2 ,3 ]
Peng, Meng-Si [4 ]
Wang, Rui [2 ]
Wang, Yi-Zu [5 ]
Chen, Chang-Cheng [6 ]
Wang, Juan [7 ]
Zheng, Yi-Li [2 ]
Xu, Hao-Ran [2 ]
Chen, Pei-Jie [2 ]
Wang, Xue-Qiang [1 ,2 ,3 ]
机构
[1] Wenzhou Med Univ, Affiliated Hosp 2, Dept Rehabil Med, Wenzhou 325027, Zhejiang, Peoples R China
[2] Wenzhou Med Univ, Sch Rehabil Med, Wenzhou, Zhejiang, Peoples R China
[3] Shanghai Univ Sport, Dept Sport Rehabil, Shanghai, Peoples R China
[4] Hainan Med Univ, Affiliated Hosp 2, Dept Rehabil Med, Haikou, Hainan, Peoples R China
[5] Shanghai Jiao Tong Univ, Ruijin Hosp, Sch Med, Dept Rehabil Med, Shanghai, Peoples R China
[6] Qingtian Peoples Hosp, Dept Rehabil Med, Lishui, Zhejiang, Peoples R China
[7] Changzhou Seventh Peoples Hosp, Dept Rehabil Med, Changzhou, Jiangsu, Peoples R China
基金
中国国家自然科学基金;
关键词
Treatment failure; Risk factors; Low back pain; Physical therapy modalities; DISABILITY; PEOPLE; ADULTS;
D O I
10.23736/S1973-9087.24.08033-X
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
BACKGROUND: The effect of physical therapy on pain and disability alleviation in patients with chronic low back pain (cLBP) has been demonstrated, but the risk factors for treatment failure remain unknown. AIM: To explore the associations of baseline demographic and clinical characteristics with treatment failure after physical therapy intervention for cLBP. DESIGN: A secondary analysis of a single-blind randomized clinical trial. SETTING: A rehabilitation hospital. POPULATION: A total of 98 patients with cLBP completed the 12 -month measurement. METHODS: Patients were randomly grouped into 3 -month therapeutic aquatic exercise or physical therapy modalities. The primary outcome was treatment failure, which was defined as a decrease in the numeric rating scale to less than 2.0 points at 12 -month follow-up. Associations between baseline demographic and clinical characteristics with risk of treatment failure were assessed by logistic regressions. RESULTS: The pain intensity in the failure cases was alleviated after 3 -month intervention but continuously increased at 6- and 12 -month followup (P<0.05). Old age was significantly associated with an increased risk of treatment failure (adjusted OR 3.26, 95% CI 1.11-9.60). Compared with those receiving physical therapy modalities, the patients receiving therapeutic aquatic exercise had less risk of treatment failure (adjusted OR 0.19, 95% CI 0.08-0.47), and age (P=0.022) was a modifier for this association. CONCLUSIONS: Compared with younger ones, older patients with cLBP had a higher risk of treatment failure after physical therapy and gained a stronger benefit of long-term pain alleviation from therapeutic aquatic exercise. CLINICAL REHABILITATION IMPACT: Therapeutic aquatic exercise is an effective therapy for cLBP and more helpful for preventing treatment failure than physical therapy modalities, especially for older patients.
引用
收藏
页码:477 / 486
页数:10
相关论文
共 30 条
[1]   Aquatic therapy improves pain, disability, quality of life, body composition and fitness in sedentary adults with chronic low back pain. A controlled clinical trial [J].
Angel Baena-Beato, Pedro ;
Artero, Enrique G. ;
Arroyo-Morales, Manuel ;
Robles-Fuentes, Alejandro ;
Gatto-Cardia, Maria Claudia ;
Delgado-Fernandez, Manuel .
CLINICAL REHABILITATION, 2014, 28 (04) :350-360
[2]   Proprioceptive neuromuscular facilitation training reduces pain and disability in individuals with chronic low back pain: A systematic review and meta-analysis [J].
Arcanjo, Fabio Luciano ;
Martins, Jose Vicente Pereira ;
Mote, Paulo ;
Leporace, Gustavo ;
de Oliveira, Daniella Araujo ;
de Sousa, Camila Santana ;
Saquetto, Micheli Bernadone ;
Gomes-Neto, Mansueto .
COMPLEMENTARY THERAPIES IN CLINICAL PRACTICE, 2022, 46
[3]   Non-specific low back pain [J].
Balague, Federico ;
Mannion, Anne F. ;
Pellise, Ferran ;
Cedraschi, Christine .
LANCET, 2012, 379 (9814) :482-491
[4]   Treatment effect modifiers for individuals with acute low back pain: secondary analysis of the TARGET trial [J].
Beneciuk, Jason M. ;
George, Steven Z. ;
Patterson, Charity G. ;
Smith, Clair N. ;
Brennan, Gerard P. ;
Wegener, Stephen T. ;
Roseen, Eric J. ;
Saper, Robert B. ;
Delitto, Anthony .
PAIN, 2023, 164 (01) :171-179
[5]   Prediction of Persistent Musculoskeletal Pain at 12 Months: A Secondary Analysis of the Optimal Screening for Prediction of Referral and Outcome (OSPRO) Validation Cohort Study [J].
Beneciuk, Jason M. ;
Lentz, Trevor A. ;
He, Ying ;
Wu, Samuel S. ;
George, Steven Z. .
PHYSICAL THERAPY, 2018, 98 (05) :290-301
[6]   GUIDELINES Low back pain and sciatica: summary of NICE guidance [J].
Bernstein, Ian A. ;
Malik, Qudsia ;
Carville, Serena ;
Ward, Stephen .
BMJ-BRITISH MEDICAL JOURNAL, 2017, 356
[7]   Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline [J].
Chou, Roger ;
Deyo, Richard ;
Friedly, Janna ;
Skelly, Andrea ;
Hashimoto, Robin ;
Weimer, Melissa ;
Fu, Rochelle ;
Dana, Tracy ;
Kraegel, Paul ;
Griffin, Jessica ;
Grusing, Sara ;
Brodt, Erika D. .
ANNALS OF INTERNAL MEDICINE, 2017, 166 (07) :493-+
[8]   Impact of Out-of-Pocket Expenditure on Physical Therapy Utilization for Nonspecific Low Back Pain: Secondary Analysis of the Medical Expenditure Panel Survey Data [J].
Dolot, Janet ;
Viola, Deborah ;
Shi, Qiuhu ;
Hyland, Matthew .
PHYSICAL THERAPY, 2016, 96 (02) :212-221
[9]   Age- and sex-specific effects in paravertebral surface electromyographic back extensor muscle fatigue in chronic low back pain [J].
Ebenbichler, Gerold ;
Habenicht, Richard ;
Ziegelbecker, Sara ;
Kollmitzer, Josef ;
Mair, Patrick ;
Kienbacher, Thomas .
GEROSCIENCE, 2020, 42 (01) :251-269
[10]   Expectations influence treatment outcomes in patients with low back pain. A secondary analysis of data from a randomized clinical trial [J].
Eklund, Andreas ;
De Carvalho, Diana ;
Page, Isabelle ;
Wong, Arnold ;
Johansson, Melker S. ;
Pohlman, Katherine A. ;
Hartvigsen, Jan ;
Swain, Michael .
EUROPEAN JOURNAL OF PAIN, 2019, 23 (07) :1378-1389