Predictors for Poor Outcomes at Six Months on Pain, Disability, Psychological and Health Status in Greek Patients with Chronic Low Back Pain After Receiving Physiotherapy: A Prospective Cohort Study
<b>Background:</b> Although previous studies have suggested a variety of sociodemographic and psychological factors as predictors of poor outcomes in patients with chronic low back pain (CLBP), longitudinal studies remain rare. <b>Objectives</b>: To examine the prognostic indicators for poor outcome at 6 months on pain, disability, quality of life, anxiety, depression and somatic symptom disorders (SSDs) in Greek backache patients and to evaluate the medium-term effects of a conservative physiotherapeutic approach (massage, ultrasound, transcutaneous electrical nerve stimulation, low-level laser and exercise program). <b>Methods</b>: A prospective cohort study of 145 volunteers receiving treatment for CLBP in a physiotherapy unit was conducted using random systematic sampling. The intervention was assessed by comparing pre-treatment, post-treatment and six-month measurements with Friedman's test and the Bonferroni correction, using the pain numerical rating scale (PNRS), Roland-Morris disability questionnaire (RMDQ), EuroQol-5-dimension-5-level (EQ-5D-5L), Hospital Anxiety and Depression Scale (HADS) and Somatic Symptom Scale-8 (SSS-8). Multiple linear regression analysis was carried out to determine the impact of demographics and pre-treatment scores with scores at six months. <b>Results:</b> The mean age was 60.6 years (±14.7). Post-treatment, statistically significant improvements were observed across all outcome measures, including PNRS, RMDQ, EQ-5D-5L and SSS-8 (all <i>p</i> ≤ 0.001), with anxiety showing a notable reduction (<i>p</i> = 0.002). After examining the multiple regression analysis, pre-treatment SSS-8 emerged as a predictor of elevated levels of pain, disability, anxiety and depression at 6 months. <b>Conclusions</b>: The findings yielded not only somatic symptom burden, greater age and pain intensity as prognostic indicators for poor outcomes at six months, but also reported favorable medium-term effects for a conventional physiotherapy regimen in CLBP management, as well.
Authors
- Ioannis Michopoulos (ORCID: https://orcid.org/0000-0003-3217-0218)
- Vasileios S. Nikolaou (ORCID: https://orcid.org/0000-0001-7422-4195)
- Konstantinos Soultanis
- Georgios Krekoukias (ORCID: https://orcid.org/0000-0003-4760-6766)
- Matthaios Petrelis (ORCID: https://orcid.org/0000-0002-3040-0676)
Institutions
- National and Kapodistrian University of Athens (GR)
- University of West Attica (GR)
Publication Details
- Journal
- Clinics and Practice
- Published
- 2025-03-16
- DOI
- https://doi.org/10.3390/clinpract15030063
- Citations
- 1
- Primary Topic
- Musculoskeletal pain and rehabilitation
- Type
- article
- Field-Weighted Citation Impact
- 1.39