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.

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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
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article

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

Ioannis Michopoulos, Vasileios S. Nikolaou, Konstantinos Soultanis, Georgios Krekoukias et al.
1 citations
Clinics and Practice
Musculoskeletal pain and rehabilitation
1.39
article

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

Ioannis Michopoulos, Vasileios S. Nikolaou, Konstantinos Soultanis, Georgios Krekoukias, Matthaios Petrelis
article en
1 citations

Abstract

<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.

Clinics and PracticeVol. 15(3)
National and Kapodistrian University of Athens (GR), University of West Attica (GR)
No poverty
Openalex Percentile: Top 23%
Musculoskeletal pain and rehabilitation
1.39
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