Very little data is available on the course of and predictors for disability in patients with chronic non-specific low back pain (CNSLBP). The authors conducted this study to describe the course and identify clinically important prognostic factors of low-back-pain-specific disability in CNSLBP patients participating in multidisciplinary therapy. A total of 1760 patients with CNSLBP who received multidisciplinary therapy were evaluated for their course and prognostic factors at baseline and at 2, 5 and 12-months follow-up. Recovery was defined as a 30% improvement in low-back-pain-specific disability at follow-up compared to baseline, and an absolute recovery if the score on the Quebec Back Pain Disability Scale (QBPDS) was ≤ 20 points at follow-up. Potential prognostic factors were identified using multivariable logistic regression analysis. Patient-reported disability scores ranged from 51.7 (SD 15.6) at baseline to 31.7 (SD 15.2), 31.1 (SD 18.2) and 29.1 (SD 20.0) on the QBPDS at 2, 5 and 12 months, respectively. The prognostic factors identified for recovery at 5 and 12 months were younger age, high scores on disability, and on the SF-36 (physical and mental component scales) at baseline. In addition, at 5-months follow-up a shorter duration of complaints was a positive predictor, while having no co-morbidity and less pain at baseline were additional predictors at 12-months follow-up. Missing values at 5 and 12-months follow-up were 11.1% and 45.2%, respectively.
They found that following multidisciplinary treatment, the course of disability in patients with CNSPBP continues to decline over a 12-month period. At 5 and 12-months follow-up prognostic factors were identified for a clinically relevant decrease in disability scores on the QBPDS.