Biopsychosocial predictors of short-term success among people with low back pain referred to a physiotherapy spinal triage service

A spinal triage assessment service could affect a wide range of patient outcomes. Examining possible predictors of success or improvement may reveal why some people improve and some do not, as well as help to begin to explain potential mechanisms for improvements. The aim of this study was to determine which factors were associated with improved short-term self-reported pain, function, general health status, and satisfaction in people undergoing a spinal triage assessment performed by physiotherapists. Despite the complex and chronic presentation of most participants, some reported improvements in outcomes at 4 weeks after assessment with the highest proportion of participants demonstrating improvement (according to the minimal important change scores) in the Medical Outcomes Survey 36-item short-form version 2 physical component summary score (48.6%) and the lowest proportion of participants having improvements in the Numeric Pain Rating Scale (11.5%). A variety of different sociodemographic, psychological, clinical, and other variables were related to success or improvement in each respective outcome.

There could be a potential mechanism of reassurance that occurs during the spinal triage assessment process as those with higher psychological distress (measured by the Fear Avoidance Beliefs Questionnaire and the Distress and Risk Assessment Measure) would more probably see improvent on certain outcomes. The use of an evaluation framework guided by a biopsychosocial model could assist in the determination of potential mechanisms of action for a physiotherapy-delivered triage program.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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