Psychological Features and Their Relationship to Movement-Based Subgroups in People Living With Low Back Pain

Publication date: January 2018
Source:Archives of Physical Medicine and Rehabilitation, Volume 99, Issue 1
Author(s): Nicholas V. Karayannis, Gwendolen A. Jull, Michael K. Nicholas, Paul W. Hodges
ObjectiveTo determine the distribution of higher psychological risk features within movement-based subgroups for people with low back pain (LBP).DesignCross-sectional observational study.SettingParticipants were recruited from physiotherapy clinics and community advertisements. Measures were collected at a university outpatient-based physiotherapy clinic.ParticipantsPeople (N=102) seeking treatment for LBP.InterventionsParticipants were subgrouped according to 3 classification schemes: Mechanical Diagnosis and Treatment (MDT), Treatment-Based Classification (TBC), and O'Sullivan Classification (OSC).Main Outcome MeasuresQuestionnaires were used to categorize low-, medium-, and high-risk features based on depression, anxiety, and stress (Depression, Anxiety, and Stress Scale–21 Items); fear avoidance (Fear-Avoidance Beliefs Questionnaire); catastrophizing and coping (Pain-Related Self-Symptoms Scale); and self-efficacy (Pain Self-Efficacy Questionnaire). Psychological risk profiles were compared between movement-based subgroups within each scheme.ResultsScores across all questionnaires revealed that most patients had low psychological risk profiles, but there were instances of higher (range, 1%–25%) risk profiles within questionnaire components. The small proportion of individuals with higher psychological risk scores were distributed between subgroups across TBC, MDT, and OSC schemes.ConclusionsMovement-based subgrouping alone cannot inform on individuals with higher psychological risk features.



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