Dhondt Evy, Van Oosterwijck Jessica, Cagnie Barbara, Adnan Rahmat, Schouppe Stijn, Van Akeleyen Jens, Logghe Tine, Danneels Lieven
SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Campus UZ Ghent, 9000 Ghent, Belgium.
Pain in Motion International Research Group.
J Back Musculoskelet Rehabil. 2020;33(2):277-293. doi: 10.3233/BMR-181125.
There is a growing need to identify patient pre-treatment characteristics that could predict adherence and outcome following specific interventions.
To identify predictors of adherence and outcome to outpatient multimodal rehabilitation in chronic low back pain (CLBP).
A total of 273 CLBP patients participated in an exercise-based rehabilitation program. Patients who completed ⩾ 70% of the treatment course were classified as adherent. Patients showing a post-treatment reduction of ⩾ 30% in Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) back pain intensity scores were assigned to the favorable outcome group.
Multivariate logistic regression revealed that higher age, higher ability to perform low-load activities, and higher degrees of kinesiophobia increased the odds to complete the rehabilitation program. By contrast, lower levels of education and back pain unrelated to poor posture increased the odds for non-adherence. Furthermore, a favorable outcome was predicted in case the cause for LBP was known, shorter symptom duration, no pain in the lower legs, no difficulties falling asleep, and short-term work absenteeism.
Assessment and consideration of patient pre-treatment characteristics is of great importance as they may enable therapists to identify patients with a good prognosis or at risk for non-responding to outpatient multimodal rehabilitation.
识别能够预测特定干预措施后患者依从性和治疗结果的治疗前特征的需求日益增长。
确定慢性下腰痛（CLBP）患者门诊多模式康复治疗依从性和治疗结果的预测因素。
共有273例CLBP患者参与了一项基于运动的康复计划。完成治疗疗程⩾70%的患者被归类为依从性好。治疗后Oswestry功能障碍指数（ODI）和视觉模拟量表（VAS）背痛强度评分降低⩾30%的患者被归入良好治疗结果组。
多因素逻辑回归显示，年龄较大、进行低负荷活动的能力较强以及运动恐惧程度较高会增加完成康复计划的几率。相比之下，教育程度较低以及与不良姿势无关的背痛会增加不依从的几率。此外，如果已知腰痛的病因、症状持续时间较短、小腿无疼痛、入睡无困难以及短期旷工，则预测会有良好的治疗结果。
评估和考虑患者的治疗前特征非常重要，因为这可能使治疗师能够识别出预后良好或有门诊多模式康复治疗无反应风险的患者。
