Prognostic Factors for Recovery in Chronic Nonspecific Low Back Pain: A Systematic Review
Verkerk, Karin (2012). Prognostic Factors for Recovery in Chronic Nonspecific Low Back Pain: A Systematic Review . Physical Therapy (sous presse, version électronique)
Background Few data are available on predictors for a favorable outcome in patients with chronic non-specific low back pain (CNLBP). Purpose To assess prognostic factors for pain intensity, disability, return to work, quality of life, or global perceived effect in patients with CNLBP at short-term (≤ 6 months) and long-term (> 6 months) follow-up. Data Sources Relevant studies evaluating the prognosis of CNLBP were searched in PubMed, Cinahl and Embase (through March 2010). Study Selection Articles were included for all types of study design; patients suffering from CNLBP (≥ 12 weeks duration); were older than 18 years; and the study is related to prognostic factors for recovery. Fourteen studies met the inclusion criteria. Data Extraction One author extracted the data and details of each study. Data Synthesis A qualitative analysis using ‘level of evidence' was performed for all included studies. Data was summarized in tables and critically appraised. Limitations The results of the studies reviewed were limited by their methodological weaknesses. Conclusion At short-term no association was found for the factors age and gender, with outcome pain intensity and disability; on the long-term, smoking had the same result. At long-term, pain intensity and fear of movement had no association with disability. On the short-term, conflicting evidence was found for the association between pain intensity or disability and the factor fear of movement. On the long-term, conflicting evidence was found for the factors age, gender and physical job demands. At long-term, conflicting evidence was found for the association between return to work and age, gender and activities of daily living. Limited evidence was there for lower pain intensity and physical job demands at baseline for a positive influence on return to work. No high-quality studies were found for the outcome quality of life and global perceived effect.