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Identification of prognostic factors for chronicity in patients with low back pain: a review of screening instruments

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Abstract

Low back pain (LBP) is currently the most prevalent and costly musculoskeletal problem in modern societies. Screening instruments for the identification of prognostic factors in LBP may help to identify patients with an unfavourable outcome. In this systematic review screening instruments published between 1970 and 2007 were identified by a literature search. Nine different instruments were analysed and their different items grouped into ten structures. Finally, the predictive effectiveness of these structures was examined for the dependent variables including “work status“, “functional limitation”, and “pain“. The strongest predictors for “work status” were psychosocial and occupational structures, whereas for “functional limitation” and “pain” psychological structures were dominating. Psychological and occupational factors show a high reliability for the prognosis of patients with LBP. Screening instruments for the identification of prognostic factors in patients with LBP should include these factors as a minimum core set.

Résumé

La lombalgie (LBP) est un problème important notamment sur le poste des dépenses dans nos sociétés modernes. Sur le plan évolutif, il est primordial de pouvoir dépister des facteurs pronostics négatifs de ces patients. entre 1970 et 2007, un certain nombre d’éléments permettant cette analyse ont été identifiés dans la littérature. Ces instruments d’analyse nous semblent importants de façon à déterminer la limitation fonctionnelle, les possibilités de travail et la douleur. l’élément de prévision le plus important pour la poursuite d’un emploi est psychosocial, de ce fait l’élément important pour apprécier le pronostic de limitation fonctionnelle ou de douleur est plutôt psychologique. les facteurs psychologiques et sociaux permettent de faire le pronostic des lombalgies, il s’agit d’un tronc commun des éléments de dépistage, devant inclure tous ces facteurs.

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Acknowledgements

This project was supported by the National Research Programme NRP 53 “Musculoskeletal Health - Chronic Pain” of the Swiss National Science Foundation (Project 405340-104826).

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Correspondence to C. Egli Presland.

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Melloh, M., Elfering, A., Egli Presland, C. et al. Identification of prognostic factors for chronicity in patients with low back pain: a review of screening instruments. International Orthopaedics (SICOT) 33, 301–313 (2009). https://doi.org/10.1007/s00264-008-0707-8

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  • DOI: https://doi.org/10.1007/s00264-008-0707-8

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