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Ahmed S, Visca R, Gogovor A, Eilayyan O, Finlayson R, Valois MF, Ware MA. Implementation of an integrated primary care prevention and management program for chronic low back pain (LBP): patient-reported outcomes and predictors of pain interference after six months. BMC Health Serv Res 2024; 24:611. [PMID: 38725037 PMCID: PMC11083802 DOI: 10.1186/s12913-024-11031-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Integrated primary care programs for patients living with chronic pain which are accessible, interdisciplinary, and patient-centered are needed for preventing chronicity and improving outcomes. Evaluation of the implementation and impact of such programs supports further development of primary care chronic pain management. This study examined patient-reported outcomes among individuals with low back pain (LBP) receiving care in a novel interdisciplinary primary care program. METHODS Patients were referred by primary care physicians in four regions of Quebec, Canada, and eligible patients received an evidence-based interdisciplinary pain management program over a six-month period. Patients were screened for risk of chronicity. Patient-reported outcome measures of pain interference and intensity, physical function, depression, and anxiety were evaluated at regular intervals over the six-month follow-up. A multilevel regression analysis was performed to evaluate the association between patient characteristics at baseline, including risk of chronicity, and change in pain outcomes. RESULTS Four hundred and sixty-four individuals (mean age 55.4y, 63% female) completed the program. The majority (≥ 60%) experienced a clinically meaningful improvement in pain intensity and interference at six months. Patients with moderate (71%) or high risk (81%) of chronicity showed greater improvement in pain interference than those with low risk (51%). Significant predictors of improvement in pain interference included a higher risk of chronicity, younger age, female sex, and lower baseline disability. CONCLUSION The outcomes of this novel LBP program will inform wider implementation considerations by identifying key components for further effectiveness, sustainability, and scale-up of the program.
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Affiliation(s)
- Sara Ahmed
- Faculty of Medicine, School of Physical & Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montreal, QC, H3G 1Y5, Canada.
- Faculty of Medicine, Family Medicine, McGill University, 5858, Chemin de La Côte-Des-Neiges 3 Floor, Montreal, QC, H3S 1Z1, Canada.
- Faculty of Medicine, Family Medicine and Emergency Medicine, Université Laval, Montreal, QC, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Lethbridge Layton Mackay Rehabilitation, CIUSSS West-Central Montreal, Montreal, QC, Canada.
- Research Institute of the McGill University Health Center, Clinical Epidemiology, Montreal, QC, Canada.
| | - Regina Visca
- Faculty of Medicine, Family Medicine, McGill University, 5858, Chemin de La Côte-Des-Neiges 3 Floor, Montreal, QC, H3S 1Z1, Canada
- Centre of Expertise in Chronic Pain of the Réseau Universitaire Intégré de Santé Et Services Sociaux McGill, 1650 Cedar Ave., Montreal, QC, H3G 1A4, Canada
- Alan Edwards Pain Management Unit of the McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada
| | - Amede Gogovor
- Faculty of Medicine, Family Medicine and Emergency Medicine, Université Laval, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Owis Eilayyan
- Faculty of Applied Medical Sciences, Physical Therapy Department, Al-Ahliyya Amman University, Amman, Jordan
| | - Roderick Finlayson
- Alan Edwards Pain Management Unit of the McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada
| | | | - Mark A Ware
- Faculty of Medicine, Family Medicine, McGill University, 5858, Chemin de La Côte-Des-Neiges 3 Floor, Montreal, QC, H3S 1Z1, Canada
- Alan Edwards Pain Management Unit of the McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada
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Impact of Work-Related Chronic Low Back Pain on Functional Performance and Physical Capabilities in Women and Men: A Sex-Wise Comparative Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6307349. [PMID: 35281614 PMCID: PMC8913110 DOI: 10.1155/2022/6307349] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/16/2022] [Indexed: 01/07/2023]
Abstract
Purpose This study is aimed at determining the impact of work-related low back pain (LBP) on functional performance and physical capabilities. Methods This cross-sectional study included women (n = 25, mean age, 38.12 ± 4.59) and men (n = 25, mean age, 37.20 ± 5.38) with a history of work-related mechanical chronic LBP who visited our university hospital's outpatient department. All participants were assessed for primary outcomes, including the severity of LBP on rest and on activity, functional performance, and physical capabilities using a numeric pain rating scale (NPRS), Roland-Morris disability questionnaire (RDQ), five-time sit-to-stand test (FTSST), and fifty-foot walk test (FFWT), respectively. Independent t-tests compared the scores of the outcomes between groups while Pearson's correlation coefficient identified the correlation between the outcomes' measures at a significance level of 0.05. Results With a response rate of 63.29%, a total of fifty participant's data were obtained for the analysis. A comparison between women and men groups highlighted a significant difference in the scores of the FTSST and FFWT; however, there were insignificant differences in the scores of the NPRS at rest, NPRS on activity, and RDQ. The bivariate correlation revealed a highly significant, positive, and moderate correlation between the scores of NPRS at rest and FTSST, NPRS on activity and FTSST, NPRS at rest and FFWT, NPRS on activity and FFWT, FTSST and RDQ, and FFWT and RDQ in the women group. Similarly, there was a significant, positive, and low correlation between the scores of FTSST and RDQ and FFWT and RDQ in the men group. Conclusion Work-related chronic LBP affected the physical capabilities of women more than those of men. However, it equally affected the functional performance of all participants in the study. Furthermore, work-related chronic LBP affected the physical capabilities (FTSST and FFWT) and functional performance (RDQ) of women more than those of men.
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Ardito RB, Pirro PS, Re TS, Bonapace I, Menardo V, Bruno E, Gianotti L. Mindfulness-Based Stress Reduction Program on Chronic Low-Back Pain: A Study Investigating the Impact on Endocrine, Physical, and Psychologic Functioning. J Altern Complement Med 2017; 23:615-623. [DOI: 10.1089/acm.2016.0423] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Rita B. Ardito
- Department of Psychology, University of Torino, Torino, Italy
- Center for Cognitive Science, University of Torino, Torino, Italy
| | | | - Tania S. Re
- UNESCO Chair, Anthropology of Health, Biosphere and Healing Systems, University of Genova, Genova, Italy
| | | | - Valentino Menardo
- Pain Management Unit, Department of Medical Emergency, ASO S. Croce & Carle Hospital, Cuneo, Italy
| | - Emanuela Bruno
- Pain Management Unit, Department of Medical Emergency, ASO S. Croce & Carle Hospital, Cuneo, Italy
| | - Laura Gianotti
- Division of Endocrinology and Metabolism, Department of Internal Medicine, ASO S. Croce & Carle Hospital, Cuneo, Italy
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Suso-Ribera C, Gallardo-Pujol D. Personality and health in chronic pain: Have we failed to appreciate a relationship? PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.02.063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Carvalho AR, Ribeiro Bertor WR, Briani RV, Zanini GM, Silva LI, Andrade A, Peyré-Tartaruga LA. Effect of Nonspecific Chronic Low Back Pain on Walking Economy: An Observational Study. J Mot Behav 2015; 48:218-26. [PMID: 26403060 DOI: 10.1080/00222895.2015.1079162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The authors investigated the effects of chronic low back pain (LBP) and walking speed (WS) on metabolic power and cost of transport (CT). Subjects with chronic nonspecific LBP (LBP group [LG]; n = 9) and healthy (control group [CG]; n = 9) were included. The test battery was divided into 3 blocks according to WS as follows: preferred self-selected speed (PS), and lower and higher than the PS. In each block, the volunteers walked 5 min, during which oxygen consumption was measured. Although without differences between groups, the LG had CT lower in slower speeds than in faster speeds. Walking speed affected CT only in the LG, which the group had the greatest walking economy at slower speeds.
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Affiliation(s)
- Alberito Rodrigo Carvalho
- a Fisioterapia, Clínica de Fisioterapia (Unioeste), Universidade Estadual do Oeste do Paraná , Cascavel , Brazil.,d Educação Física, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Welds Rodrigo Ribeiro Bertor
- a Fisioterapia, Clínica de Fisioterapia (Unioeste), Universidade Estadual do Oeste do Paraná , Cascavel , Brazil
| | | | - Gabriela Matté Zanini
- a Fisioterapia, Clínica de Fisioterapia (Unioeste), Universidade Estadual do Oeste do Paraná , Cascavel , Brazil
| | - Lígia Inez Silva
- a Fisioterapia, Clínica de Fisioterapia (Unioeste), Universidade Estadual do Oeste do Paraná , Cascavel , Brazil
| | - Alexandro Andrade
- c Educação Física, Universidade Estadual de Santa Catarina , Florianópolis , Brazil
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Angeletti C, Guetti C, Ursini ML, Taylor R, Papola R, Petrucci E, Ciccozzi A, Paladini A, Marinangeli F, Pergolizzi J, Varrassi G. Low back pain in a natural disaster. Pain Pract 2013; 14:E8-16. [PMID: 23763663 DOI: 10.1111/papr.12087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 04/22/2013] [Indexed: 11/26/2022]
Abstract
UNLABELLED Low back pain is usually self-limited. The transition from acute to chronic LBP is influenced by physical and psychological factors. Identification of all contributing factors, in a mass emergency setting, differentiating primary and secondary life-threatening forms of LBP, is the best approach for success. Aims of the present report were to estimate the prevalence of LBP in population afferent to four advanced medical presidiums (AMPs) during postseismic emergency period and to evaluate frequency of use, types of pain killers administered to patients and short-term efficacy of them. METHODS Study was carried out in four AMPs during the first 5 weeks after the earthquake. Site, type of eventual trauma, pain intensity during LBP episode by Verbal Numerical Rating Scale (vNRS) were registered. Diagnosis of primary or secondary LBP was made on the basis of clinical features and therapeutic treatment was also analyzed. RESULTS The prevalence of acute LBP was 4.9% (95%, IC 3.7 to 6.4), among 958 first accesses to AMP, representing 14.1% (95%, IC 10.8 to 18.3) of cases on the total of 322 patients treated for all pain conditions. Episodes of relapsed LBP in chronic pre-existing LBP represented the 40% (n = 19) of cases, while the first episode was present in 60% of patients (n = 28). Pain treatment was effective with a significant reduction in vNRS in short term evaluation. CONCLUSIONS The emotional stress induced by natural disaster tends to heighten norepinephrine and sympathetic nervous system activity, which may further amplify nociception through peripheral or central mechanisms that result in consistent prevalence of primary NSLBP and become potential risk factor for pain chronicization.
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Affiliation(s)
- Chiara Angeletti
- Anesthesiology and Pain Medicine, Department of Life Health and Environmental Sciences, University of L'Aquila - VADO, Voluntary Association for Home Medical Care, L'Aquila, Italy
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Evaluation of a Randomized Controlled Trial in the Management of Chronic Lower Back Pain in a French Automotive Industry: An Observational Study. Arch Phys Med Rehabil 2011; 92:1927-1936.e4. [DOI: 10.1016/j.apmr.2011.06.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 06/28/2011] [Accepted: 06/28/2011] [Indexed: 12/31/2022]
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Steiner D, Munera C, Hale M, Ripa S, Landau C. Efficacy and Safety of Buprenorphine Transdermal System (BTDS) for Chronic Moderate to Severe Low Back Pain: A Randomized, Double-Blind Study. THE JOURNAL OF PAIN 2011; 12:1163-73. [DOI: 10.1016/j.jpain.2011.06.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 05/18/2011] [Accepted: 06/03/2011] [Indexed: 11/16/2022]
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Gerhardt A, Hartmann M, Schuller-Roma B, Blumenstiel K, Bieber C, Eich W, Steffen S. The Prevalence and Type of Axis-I and Axis-II Mental Disorders in Subjects with Non-Specific Chronic Back Pain: Results from a Population-Based Study. PAIN MEDICINE 2011; 12:1231-40. [DOI: 10.1111/j.1526-4637.2011.01190.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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