Objectives
The aims of the study are to describe the low-back pain and disability status at baseline,
the fourth visit, and at 3 and 12 months in Norwegian patients treated by chiropractors
for persistent low back pain (LBP) and to describe movements between various subgroups
over time.
Design
Prospective uncontrolled multicenter study.
Methods
Self-reported pain was measured with a 0-10 box scale and disability with the revised
Oswestry LBP questionnaire. The main outcome measures were mean pain or disability
values and numbers of LBP-free patients. LBP status was assessed through patient questionnaires
at baseline, the fourth visit, and after 3 and 12 months.
Study Subjects and Setting
Of 205 invited chiropractors, 115 Norwegian chiropractors were each willing to recruit
10 consecutive patients who had LBP for at least 2 weeks at the time of consultation
and a minimum of 30 days altogether within the preceding year. The numbers of participants
were 875 (baseline), 799 (fourth visit), 598 (3 months), and 512 (12 months).
Results
Considerable improvement was noted between baseline and the fourth visit both for
mean values and in numbers of LBP-free patients. There was virtually no further mean
improvement up to the third month, whereas the number of LBP-free individuals doubled.
At 12 months, no additional improvement was noted, and 80% reported that they had
experienced recurrent problems. Less than 1% reported considerable worsening. Severity
of symptoms at baseline determined the subsequent outcome, mild symptoms tending to
worsen, and severe symptoms tending to improve.
Conclusion
The outcome pattern is similar to that found in other clinical studies. Treatment
outcome should be measured early with follow-up at 3 rather than at 12 months, because
patients will improve or recover quickly but may experience recurring problems. Numbers
“cured” appear to be a feasible outcome variable in this type of study population.
Key Indexing Terms
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Article info
Footnotes
Sources of support: funding was provided by the Research Council of Norway and the Swedish Chiropractic Association.
Identification
Copyright
© 2005 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
