Nature and determinants of the course of chronic low back pain over a 12-month period: a cluster analysis

Macedo, Luciana Gazzi, Maher, Christopher G., Latimer, Jane, McAuley, James H., Hodges, Paul W. and Rogers, W. Todd (2014) Nature and determinants of the course of chronic low back pain over a 12-month period: a cluster analysis. Physical Therapy, 94 2: 210-221. doi:10.2522/ptj.20120416

Author Macedo, Luciana Gazzi
Maher, Christopher G.
Latimer, Jane
McAuley, James H.
Hodges, Paul W.
Rogers, W. Todd
Title Nature and determinants of the course of chronic low back pain over a 12-month period: a cluster analysis
Journal name Physical Therapy   Check publisher's open access policy
ISSN 0031-9023
Publication date 2014-01-01
Year available 2013
Sub-type Article (original research)
DOI 10.2522/ptj.20120416
Open Access Status DOI
Volume 94
Issue 2
Start page 210
End page 221
Total pages 12
Place of publication Alexandria, VA, United States
Publisher American Physical Therapy Association
Language eng
Formatted abstract
Background: It has been suggested that low back pain (LBP) is a condition with an unpredictable pattern of exacerbation, remission, and recurrence. However, there is an incomplete understanding of the course of LBP and the determinants of the course.

Objective: The purposes of this study were: (1) to identify clusters of LBP patients with similar fluctuating pain patterns over time and (2) to investigate whether demographic and clinical characteristics can distinguish these clusters.

Design: This study was a secondary analysis of data extracted from a randomized controlled trial.

Methods: Pain scores were collected from 155 participants with chronic nonspecific LBP. Pain intensity was measured monthly over a 1-year period by mobile phone short message service. Cluster analysis was used to identify participants with similar fluctuating patterns of pain based on the pain measures collected over a year, and t tests were used to evaluate if the clusters differed in terms of baseline characteristics.

Results: The cluster analysis revealed the presence of 3 main clusters. Pain was of fluctuating nature within 2 of the clusters. Out of the 155 participants, 21 (13.5%) had fluctuating pain. Baseline disability (measured with the Roland-Morris Disability Questionnaire) and treatment groups (from the initial randomized controlled trial) were significantly different in the clusters of patients with fluctuating pain when compared with the cluster of patients without fluctuating pain.

Limitations: A limitation of this study was the fact that participants were undergoing treatment that may have been responsible for the rather positive prognosis observed.

Conclusions: A small number of patients with fluctuating patterns of pain over time were identified. This number could increase if individuals with episodic pain are included in this fluctuating group.
Keyword Orthopedics
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
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