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Ardakani EM, Leboeuf-Yde C, Jacques A, Walker BF. The prognostic merit of self-reported triggers of recurrent low back pain: study protocol. Chiropr Man Therap 2020; 28:1. [PMID: 31969980 PMCID: PMC6964026 DOI: 10.1186/s12998-019-0291-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 12/23/2019] [Indexed: 12/12/2022] Open
Abstract
Background Most cases of low back pain (LBP) are regarded as non-specific and current studies indicate that for many this is a chronic recurrent condition, in which people experience episodes of pain with symptom-free periods in between. It is likely that acute exposure to some factors triggers the reappearance of new episodes in recurrent LBP regardless of the causality of the underlying condition (i.e. risk factors). Additionally, it has been shown that LBP patients present with different trajectories and different trajectories possibly have different triggers. Hence, dividing patients into some clinically meaningful subgroups may offer new insights into triggers, effective preventive strategies and, therefore, prognosis. This study aims to identify self-reported triggers and trajectories of episodes of recurrent LBP and to examine the prognostic association between different triggers and LBP trajectories. Methods This is a longitudinal, multicentre, Australia-wide observational study of patients with recurrent non-specific LBP. Two hundred adults with at least a one-year history of LBP will be recruited from primary care clinics or private practices and followed for a year. Each will receive an SMS every fortnight (26 time-points in total) enquiring the occurrence of a new episode of pain in the past 2 weeks and its intensity. Upon report of a new episode, a telephone interview will be performed to appraise exposure to self-nominated triggers in a period of 24 h preceding the pain. Trajectories will be identified by latent class analysis at the end of the follow-up based on the pain intensity, frequency, and length of episodes. Triggers will be categorised into physical and psychosocial groups. Generalised linear mixed models with logit links will be used to explore pain triggers associated with pain trajectories. Discussion The completion of this study will provide insight into the patients' self-reported triggers of LBP and also their possible prognostic association with different trajectories. Some newly-identified and pre-identified triggers are likely to be found and reported.
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Affiliation(s)
- Emad M. Ardakani
- College of Science, Health, Engineering, and Education, Murdoch University, Murdoch, 90 South St, Murdoch, Perth, Western Australia 6150
| | - Charlotte Leboeuf-Yde
- College of Science, Health, Engineering, and Education, Murdoch University, Murdoch, 90 South St, Murdoch, Perth, Western Australia 6150
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Angela Jacques
- College of Science, Health, Engineering, and Education, Murdoch University, Murdoch, 90 South St, Murdoch, Perth, Western Australia 6150
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Australia
| | - Bruce F. Walker
- College of Science, Health, Engineering, and Education, Murdoch University, Murdoch, 90 South St, Murdoch, Perth, Western Australia 6150
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Pagé GM, Lacasse A, Beaudet N, Choinière M, Deslauriers S, Diatchenko L, Dupuis L, Grégoire S, Hovey R, Leclair E, Leonard G, Meloto CB, Montagna F, Parent A, Rainville P, Roy JS, Roy M, Ware MA, Wideman TH, Stone LS. The Quebec Low Back Pain Study: a protocol for an innovative 2-tier provincial cohort. Pain Rep 2020; 5:e799. [PMID: 32072095 PMCID: PMC7004506 DOI: 10.1097/pr9.0000000000000799] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/02/2019] [Accepted: 10/24/2019] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION The neurobiological mechanisms underlying recovery from or persistence of low back pain (LBP) remain misunderstood, limiting progress toward effective management. We have developed an innovative two-tier design to study the transition from acute to chronic LBP. The objective of the first tier is to create a provincial web-based infrastructure to recruit and monitor the trajectory of individuals with acute LBP. The objective of the second tier is to fuel hypothesis-driven satellite data collection centers with specialized expertise to study the role of biomechanical, epigenetic, genetic, neuroanatomical, ontological, physiological, psychological, and socioeconomic factors in LBP chronicity. METHODS This article describes the first tier of the protocol: establishment of the Core Dataset and Cohort. Adults with acute LBP will be recruited through networks, media, and health care settings. A web-based interface will be used to collect self-reported variables at baseline and at 3, 6, 12, and 24 months. Acute LBP will be defined according to the Dionne 2008 consensus. Measurements will include the Canadian minimum data set for chronic LBP research, DN4 for neuropathic pain, comorbidities, EQ-5D-5L for quality of life, and linkage with provincial medico-administrative databases. The primary outcome will be the transition to chronic LBP, as defined by Deyo 2014. Secondary outcomes include health care resource utilization, disability, sick leave, mood, and quality of life. PERSPECTIVE This study brings together diverse research expertise to investigate the transition from acute to chronic LBP, characterize the progression to recovery or chronicity, and identify patterns associated with that progression.
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Affiliation(s)
- Gabrielle M. Pagé
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Anaïs Lacasse
- Départment des sciences de la santé, Université du Québec en Abitibi-Témiscamingue, QC, Canada
| | - the Quebec Back Pain Consortium (in alphabetical order)
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
- Départment des sciences de la santé, Université du Québec en Abitibi-Témiscamingue, QC, Canada
- Quebec Pain Research Network, QC, Canada
- Department of Anesthesiology, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier de l'Université de Sherbrooke (CRCHUS), Sherbrooke, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS, CIUSSS-CN), Quebec City, QC, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
- Alan Edwards Centre for Research on Pain, McGill University Health Centre (MUHC), QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Research Center on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie—Centre Hospitalier Universitaire de Sherbrooke (CIUSSS de l'Estrie—CHUS), Université de Sherbrooke, Sherbrooke, Québec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de-l'île de Montréal, Montréal, QC, Canada
- Department of Stomatology, Université de Montréal, Montréal, QC, Canada
- Groupe de Recherche sur le Système Nerveux Central (GRSNC), and Centre de recherche en Neuropsychologie et Cognition (CERNEC), Université de Montréal, Montréal, QC, Canada
- Department of Psychology, Faculty of Science, McGill University, Montreal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Nicolas Beaudet
- Quebec Pain Research Network, QC, Canada
- Department of Anesthesiology, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier de l'Université de Sherbrooke (CRCHUS), Sherbrooke, QC, Canada
| | - Manon Choinière
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Simon Deslauriers
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS, CIUSSS-CN), Quebec City, QC, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Luda Diatchenko
- Alan Edwards Centre for Research on Pain, McGill University Health Centre (MUHC), QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Laurent Dupuis
- Department of Anesthesiology, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Stéphanie Grégoire
- Alan Edwards Centre for Research on Pain, McGill University Health Centre (MUHC), QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Richard Hovey
- Alan Edwards Centre for Research on Pain, McGill University Health Centre (MUHC), QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Erwan Leclair
- Quebec Pain Research Network, QC, Canada
- Alan Edwards Centre for Research on Pain, McGill University Health Centre (MUHC), QC, Canada
| | - Guillaume Leonard
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Research Center on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie—Centre Hospitalier Universitaire de Sherbrooke (CIUSSS de l'Estrie—CHUS), Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Carolina B. Meloto
- Alan Edwards Centre for Research on Pain, McGill University Health Centre (MUHC), QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Francesca Montagna
- Alan Edwards Centre for Research on Pain, McGill University Health Centre (MUHC), QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | | | - Pierre Rainville
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de-l'île de Montréal, Montréal, QC, Canada
- Department of Stomatology, Université de Montréal, Montréal, QC, Canada
- Groupe de Recherche sur le Système Nerveux Central (GRSNC), and Centre de recherche en Neuropsychologie et Cognition (CERNEC), Université de Montréal, Montréal, QC, Canada
| | - Jean-Sébastien Roy
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS, CIUSSS-CN), Quebec City, QC, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Mathieu Roy
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de-l'île de Montréal, Montréal, QC, Canada
- Department of Psychology, Faculty of Science, McGill University, Montreal, QC, Canada
| | - Mark A. Ware
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de-l'île de Montréal, Montréal, QC, Canada
| | - Timothy H. Wideman
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de-l'île de Montréal, Montréal, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Laura S. Stone
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-sud-de-l'île de Montréal, Montréal, QC, Canada
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