Abstract
Objectives
(1) To describe the low back pain (LBP) pattern at baseline; (2) to describe the long-term
outcome pattern; (3) to investigate the presence of distinct subgroups in relation
to outcome; (4) to establish whether short-term outcome is a predictor of long-term
outcome.
Methods
A 3- to 6- and 12- to 18-month, multicenter practice–based, prospective descriptive
study was performed in private chiropractic practices in Sweden. Fifty-eight of 64
previously compliant chiropractors each recruited a maximum of 30 consecutive patients
with LBP. Complete baseline clinical information was provided on 1054 patients, of
which 93% were interviewed approximately 3 months later, and 57% responded to a questionnaire
at approximately 12 months. Chiropractic treatment was decided by the treating chiropractor.
Twelve descriptive subgroups were created based on (1) duration of LBP at baseline,
(2) duration of LBP in the past year, and (3) LBP pattern in the past year. The predictive
value was tested for outcome status at the fourth visit. Information on self-reported
LBP status and improvement over the past months were collected.
Results
Patients were spread in a U-shaped fashion from benign to severe with the 2 extreme
groups being most prevalent. About half the participants reported “no LBP in the past
week” at 3 months and somewhat fewer at 12 months. Almost 75% claimed to be definitely
better at 3 months, and approximately 50% at 12 months. Specific predictive subgroups
can be identified, mainly in relation to the past-year history of LBP. Improvement
at the fourth visit is a predictor of long-term outcome.
Conclusion
Knowledge of specific subgroups may improve the quality of care and the selection
of homogeneous study populations in clinical trials.
Key Indexing Terms
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References
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Article info
Publication history
Received:
February 3,
2004
Footnotes
Sources of support: Funding was provided by the Swedish Chiropractors' Association.
Identification
Copyright
© 2005 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
