Trajectories of acute low back pain: a latent class growth analysis

Aron Downie, Mark Hancock, Magdalena Rzewuska, Christine Lin, Christopher Williams, Christopher Maher

Research output: Contribution to journalMeeting abstractResearch

Abstract

Objectives: The objective of this study was to investigate the different recovery trajectories after an episode of acute low back pain, and to explore individual characteristics that are associated with each trajectory. Methods: Participants were adults consulting general practice with acute low back pain, recruited for a placebo controlled trial of paracetamol. Pain numerical rating scale data (score range 0‐10) was collected at baseline, weeks 1, 2, 4 and 12. Latent Class Growth Analysis (LCGA) was used to identify pain trajectories, based on trichotomized pain scores (0‐1 = pain recovery, 2‐4 = moderate pain, ≥ 5 = high pain). Multinomial logistic regression analysis was used to explore patient characteristics at baseline that were associated with individual cluster membership. Results: In total, 1,477 participants who provided pain scores at all five collection points were analyzed. Six distinct clusters were identified including: ‘rapid pain recovery’ (n=518), ‘rapid pain decrease, recovery at 12 weeks’ (n=403), ‘gradual pain decrease, recovery at 12 weeks’ (n=180), ‘incomplete recovery’ (n=180), ‘persistent high pain’ (n=103) and ‘fluctuating pain’ (n=93). Higher pain, increased pain duration, and perceived risk of persistence were associated with delayed recovery trajectories when compared to rapid recovery. In addition, a higher number of previous episodes, workers' compensation, and decreased quality of life were associated with non-recovery trajectories when compared to rapid recovery. Conclusion: Overall, 25% of primary care attendees with acute low back pain show early tendency for pain persistence, recurrence or only partial recovery. Identification of patient characteristics that can influence recovery offers potential targets to improve patient outcomes.

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Low Back Pain
Pain
Growth
Workers' Compensation
Acetaminophen
General Practice
Primary Health Care

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@article{6bc4712c6b874b70aaf73cc39fcadeff,
title = "Trajectories of acute low back pain: a latent class growth analysis",
abstract = "Objectives: The objective of this study was to investigate the different recovery trajectories after an episode of acute low back pain, and to explore individual characteristics that are associated with each trajectory. Methods: Participants were adults consulting general practice with acute low back pain, recruited for a placebo controlled trial of paracetamol. Pain numerical rating scale data (score range 0‐10) was collected at baseline, weeks 1, 2, 4 and 12. Latent Class Growth Analysis (LCGA) was used to identify pain trajectories, based on trichotomized pain scores (0‐1 = pain recovery, 2‐4 = moderate pain, ≥ 5 = high pain). Multinomial logistic regression analysis was used to explore patient characteristics at baseline that were associated with individual cluster membership. Results: In total, 1,477 participants who provided pain scores at all five collection points were analyzed. Six distinct clusters were identified including: ‘rapid pain recovery’ (n=518), ‘rapid pain decrease, recovery at 12 weeks’ (n=403), ‘gradual pain decrease, recovery at 12 weeks’ (n=180), ‘incomplete recovery’ (n=180), ‘persistent high pain’ (n=103) and ‘fluctuating pain’ (n=93). Higher pain, increased pain duration, and perceived risk of persistence were associated with delayed recovery trajectories when compared to rapid recovery. In addition, a higher number of previous episodes, workers' compensation, and decreased quality of life were associated with non-recovery trajectories when compared to rapid recovery. Conclusion: Overall, 25{\%} of primary care attendees with acute low back pain show early tendency for pain persistence, recurrence or only partial recovery. Identification of patient characteristics that can influence recovery offers potential targets to improve patient outcomes.",
author = "Aron Downie and Mark Hancock and Magdalena Rzewuska and Christine Lin and Christopher Williams and Christopher Maher",
year = "2015",
doi = "10.1016/j.jcm.2015.06.002",
language = "English",
pages = "101--101",
journal = "WFC 2015 Congress proceedings : WFC'S 13th Biennial Congress Proceedings, Athens, Greece, 10-13, 2015 : abstracts of the scientific sessions",
issn = "1556-3715",
publisher = "World Federation of Chiropractic",

}

Trajectories of acute low back pain : a latent class growth analysis. / Downie, Aron; Hancock, Mark; Rzewuska, Magdalena; Lin, Christine; Williams, Christopher; Maher, Christopher.

In: WFC 2015 Congress proceedings : WFC'S 13th Biennial Congress Proceedings, Athens, Greece, 10-13, 2015 : abstracts of the scientific sessions, 2015, p. 101-101.

Research output: Contribution to journalMeeting abstractResearch

TY - JOUR

T1 - Trajectories of acute low back pain

T2 - WFC 2015 Congress proceedings : WFC'S 13th Biennial Congress Proceedings, Athens, Greece, 10-13, 2015 : abstracts of the scientific sessions

AU - Downie, Aron

AU - Hancock, Mark

AU - Rzewuska, Magdalena

AU - Lin, Christine

AU - Williams, Christopher

AU - Maher, Christopher

PY - 2015

Y1 - 2015

N2 - Objectives: The objective of this study was to investigate the different recovery trajectories after an episode of acute low back pain, and to explore individual characteristics that are associated with each trajectory. Methods: Participants were adults consulting general practice with acute low back pain, recruited for a placebo controlled trial of paracetamol. Pain numerical rating scale data (score range 0‐10) was collected at baseline, weeks 1, 2, 4 and 12. Latent Class Growth Analysis (LCGA) was used to identify pain trajectories, based on trichotomized pain scores (0‐1 = pain recovery, 2‐4 = moderate pain, ≥ 5 = high pain). Multinomial logistic regression analysis was used to explore patient characteristics at baseline that were associated with individual cluster membership. Results: In total, 1,477 participants who provided pain scores at all five collection points were analyzed. Six distinct clusters were identified including: ‘rapid pain recovery’ (n=518), ‘rapid pain decrease, recovery at 12 weeks’ (n=403), ‘gradual pain decrease, recovery at 12 weeks’ (n=180), ‘incomplete recovery’ (n=180), ‘persistent high pain’ (n=103) and ‘fluctuating pain’ (n=93). Higher pain, increased pain duration, and perceived risk of persistence were associated with delayed recovery trajectories when compared to rapid recovery. In addition, a higher number of previous episodes, workers' compensation, and decreased quality of life were associated with non-recovery trajectories when compared to rapid recovery. Conclusion: Overall, 25% of primary care attendees with acute low back pain show early tendency for pain persistence, recurrence or only partial recovery. Identification of patient characteristics that can influence recovery offers potential targets to improve patient outcomes.

AB - Objectives: The objective of this study was to investigate the different recovery trajectories after an episode of acute low back pain, and to explore individual characteristics that are associated with each trajectory. Methods: Participants were adults consulting general practice with acute low back pain, recruited for a placebo controlled trial of paracetamol. Pain numerical rating scale data (score range 0‐10) was collected at baseline, weeks 1, 2, 4 and 12. Latent Class Growth Analysis (LCGA) was used to identify pain trajectories, based on trichotomized pain scores (0‐1 = pain recovery, 2‐4 = moderate pain, ≥ 5 = high pain). Multinomial logistic regression analysis was used to explore patient characteristics at baseline that were associated with individual cluster membership. Results: In total, 1,477 participants who provided pain scores at all five collection points were analyzed. Six distinct clusters were identified including: ‘rapid pain recovery’ (n=518), ‘rapid pain decrease, recovery at 12 weeks’ (n=403), ‘gradual pain decrease, recovery at 12 weeks’ (n=180), ‘incomplete recovery’ (n=180), ‘persistent high pain’ (n=103) and ‘fluctuating pain’ (n=93). Higher pain, increased pain duration, and perceived risk of persistence were associated with delayed recovery trajectories when compared to rapid recovery. In addition, a higher number of previous episodes, workers' compensation, and decreased quality of life were associated with non-recovery trajectories when compared to rapid recovery. Conclusion: Overall, 25% of primary care attendees with acute low back pain show early tendency for pain persistence, recurrence or only partial recovery. Identification of patient characteristics that can influence recovery offers potential targets to improve patient outcomes.

U2 - 10.1016/j.jcm.2015.06.002

DO - 10.1016/j.jcm.2015.06.002

M3 - Meeting abstract

SP - 101

EP - 101

JO - WFC 2015 Congress proceedings : WFC'S 13th Biennial Congress Proceedings, Athens, Greece, 10-13, 2015 : abstracts of the scientific sessions

JF - WFC 2015 Congress proceedings : WFC'S 13th Biennial Congress Proceedings, Athens, Greece, 10-13, 2015 : abstracts of the scientific sessions

SN - 1556-3715

ER -