Characteristics and outcomes of patients with low back pain with and without radiating leg pain following the GLA:D back program

IF 2.2 3区 医学 Q1 REHABILITATION Musculoskeletal Science and Practice Pub Date : 2024-07-11 DOI:10.1016/j.msksp.2024.103144
A Khoshal Khorami , Alessandro Chiarotto , Alice Kongsted , Jan Hartvigsen , Bart W. Koes
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Abstract

Background

Some patients with low back pain (LBP) also report radiating leg pain which is a prognostic factor for poorer clinical outcomes. We aimed: 1) to compare the baseline characteristics of patients with LBP with - (LBP + leg pain) and without radiating leg pain (LBP - alone); 2) to investigate whether patients with LBP + leg pain show similar post-treatment outcomes as compared to LBP – alone, after participation in an exercise and patient education program, i.e. the GLA:D Back program.

Methods

The patient sample included 3508 patients in the GLA:D Back program between March 2018 and August 2022. The outcomes were mean changes in LBP intensity, back-related activity limitation, self-efficacy and fear of movement measured from baseline to 3, 6 and 12 months. Baseline characteristics were compared with descriptive statistics, and linear mixed models were used to estimate group differences in changes from baseline to 3-, 6- and 12 months.

Results

1915 (55%) of the patients were in the group LBP- alone and 1593 (45%) in the LBP + leg pain. The LBP + leg pain group displayed higher STarT back classification (greater risk of chronicity) compared to the LBP–alone. The LBP + leg pain group showed almost similar improvements in all outcomes compared to LBP – alone after the GLA:D Back program.

Conclusion

In long-lasting (chronic) LBP patients, the LBP + leg pain group improved to the same extent as LBP - alone regarding LBP intensity, disability, and fear of movement following an exercise and patient education program, GLA:D Back.

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伴有或不伴有腿部放射痛的腰痛患者参加 GLA:D 背部项目后的特征和疗效
背景一些腰背痛(LBP)患者还报告有腿部放射痛,这是导致临床预后较差的一个预后因素。我们的目的是:1)比较伴有放射性腿痛的腰背痛患者(腰背痛+腿痛)和没有放射性腿痛的腰背痛患者(单纯腰背痛)的基线特征;2)研究腰背痛+腿痛的患者在参与运动和患者教育计划(即 GLA:D Back 计划)后,与单纯腰背痛患者相比,是否表现出相似的治疗后结果。方法患者样本包括 2018 年 3 月至 2022 年 8 月间参与 GLA:D Back 计划的 3508 名患者。研究结果为从基线到3个月、6个月和12个月期间枸杞痛强度、背部相关活动限制、自我效能感和运动恐惧的平均变化。通过描述性统计比较基线特征,并使用线性混合模型估计从基线到3个月、6个月和12个月期间各组的变化差异。结果1915名患者(55%)属于单纯枸杞多糖症组,1593名患者(45%)属于枸杞多糖症+腿痛组。与单纯枸杞多糖症组相比,枸杞多糖症+腿痛组的 STarT 背部分级更高(慢性化风险更高)。结论在长期(慢性)椎管内疼痛患者中,椎管内疼痛+腿痛组与单纯椎管内疼痛组在运动和患者教育项目GLA:D Back后,在椎管内疼痛强度、残疾和运动恐惧方面的改善程度相同。
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来源期刊
Musculoskeletal Science and Practice
Musculoskeletal Science and Practice Health Professions-Physical Therapy, Sports Therapy and Rehabilitation
CiteScore
4.10
自引率
8.70%
发文量
152
审稿时长
48 days
期刊介绍: Musculoskeletal Science & Practice, international journal of musculoskeletal physiotherapy, is a peer-reviewed international journal (previously Manual Therapy), publishing high quality original research, review and Masterclass articles that contribute to improving the clinical understanding of appropriate care processes for musculoskeletal disorders. The journal publishes articles that influence or add to the body of evidence on diagnostic and therapeutic processes, patient centered care, guidelines for musculoskeletal therapeutics and theoretical models that support developments in assessment, diagnosis, clinical reasoning and interventions.
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