Illness perceptions; exploring mediators and/or moderators in disabling persistent low back pain. Multiple baseline single-case experimental design

BMC Musculoskeletal Disorders

J. Jos Twisk¹  R. W. J. G. Raymond Ostelo²  H. Harriet Wittink³  J. F. Francois Maissan³  E. J. Edwin de Raaij⁴ 

[1] Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands;Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam, the Netherlands;Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute, Amsterdam, the Netherlands;Research Group Lifestyle and Health, University of Applied Sciences Utrecht, Heidelberglaan 7, 3584, Utrecht, CS, The Netherlands;Research Group Lifestyle and Health, University of Applied Sciences Utrecht, Heidelberglaan 7, 3584, Utrecht, CS, The Netherlands;Department of Health Sciences, VU University, The Netherlands and the EMGO Institute for Health and Care Research, Amsterdam, The Netherlands;

关键词: Low back pain;    Illness perceptions;    Mediation;    Moderation;    SCED-study;    Physiotherapy;   

DOI  :  10.1186/s12891-022-05031-3

来源: Springer

【 摘 要 】

IntroductionIllness Perceptions (IPs) may play a role in the management of persistent low back pain. The mediation and/or moderation effect of IPs on primary outcomes in physiotherapy treatment is unknown.MethodsA multiple single-case experimental design, using a matched care physiotherapy intervention, with three phases (phases A-B-A’) was used including a 3 month follow up (phase A’). Primary outcomes: pain intensity, physical functioning and pain interference in daily life. Analyzes: linear mixed models, adjusted for fear of movement, catastrophizing, avoidance, sombreness and sleep.ResultsNine patients were included by six different primary care physiotherapists. Repeated measures on 196 data points showed that IPs Consequences, Personal control, Identity, Concern and Emotional response had a mediation effect on all three primary outcomes. The IP Personal control acted as a moderator for all primary outcomes, with clinically relevant improvements at 3 month follow up.ConclusionOur study might indicate that some IPs have a mediating or a moderating effect on the outcome of a matched care physiotherapy treatment. Assessing Personal control at baseline, as a relevant moderator for the outcome prognosis of successful physiotherapy management of persistent low back pain, should be further eplored.

【 授权许可】

CC BY