Alamam D1,2, Moloney N3, Leaver A2, Alsobayel H1, Mackey M2
1King Saud University, Riyadh, Saudi Arabia, 2The University of Sydney, Sydney, Australia, 3Macquarie University, Sydney, Australia

Background: Chronic Low Back Pain (CLBP) is one of the leading causes of disability. Among people with CLBP, identifying prognostic factors is important. No data are available on the predictors of disability related to CLBP among the Saudi population.

Purpose: The objectives of this study were to examine associations between CLBP-related disability at 12-month follow up and individual, psychosocial and physical related factors at baseline and treatment related factors between baseline and 12-month follow up. Secondary aims were to examine associations between
(a) pain intensity and
(b) general perceived efficacy (GPE) at 12-month follow-up with the aforementioned baseline and treatment related factors.

Methods: A prospective cohort study was conducted in Saudi Arabia. At baseline, participants completed questionnaires covering demographics, disability, pain intensity, back beliefs, fear avoidance, psychological distress and physical activity. They performed a standardized sequence of physical performance tests, during which a Pain Behaviour Scale was used to evaluate pain behaviours. At 12-month follow-up, participants completed questionnaires on disability, pain intensity, GPE and also provided information related to treatment received during the previous 12 months. The predictors of disability, pain and GPE were explored using univariate and multivariate regression analyses.

Results: The prognostic model for moderate-severe CLBP-related disability at 12 months explained 53.0% of the variance, with higher pain intensity, higher fear avoidance-work and older age predicting higher disability, while having no additional somatizing tendency was a predictor of lower disability. Pain intensity at 12-month follow up was explained by higher disability at baseline, while not being in paid employment seemed to be protective in this cohort (25.7% of variance explained). Sixty percent of participants reported that their back pain had improved relative to baseline and 45% reported it was much improved (GPE score ≥ 3). As univariate associations were very weak between predictor variables and GPE, multivariate analysis with GPE as a dependent variable was not conducted.

Conclusion(s): Predictors of disability in this cohort were similar to previous international reports and emphasize the multifactorial nature of CLBP-related disability. Not being in paid employment was associated with lower pain intensity at 12 months and may be related to cultural factors specific to Saudi Arabia.

Implications: This study reported important prognostic models in Saudi population. The final models identified predictive factors which can be easily assessed in clinical practice. Further evaluation of the effects of clinical management of these factors on CLBP-related disability in Saudi people is warranted.

Keywords: Chronic low back pain, prognosis, multidimensional

Funding acknowledgements: This research was funded by a scholarship grant from King Saud University, Saudi Arabia.

Topic: Musculoskeletal: spine

Ethics approval required: Yes
Institution: The University of Sydney
Ethics committee: Health Science Research Ethics Committee
Ethics number: (2015/771)

All authors, affiliations and abstracts have been published as submitted.

Back to the listing