Takasaki Hiroshi
Department of Physical Therapy, Saitama Prefectural University, Koshigaya 343-8540, Japan.
Healthcare (Basel). 2023 Apr 30;11(9):1293. doi: 10.3390/healthcare11091293.
This multicenter prospective cohort study aimed to preliminarily explore statistically relevant modifiable and predetermined factors for 1-year perceived recovery, absenteeism, and personal expenses in workers who received Mechanical Diagnosis and Therapy (MDT) for low back pain (LBP). Three stepwise multiple regression models were explored with 42 independent variables, including (1) socio-demographic factors; (2) risk stratification; (3) pain-related variables, psychological variables, and behavioral variables at baseline and changes after a month; (4) therapeutic alliance and exercise adherence at 1-month follow-up; and (5) MDT classification and therapist levels. Data from 58 participants were analyzed, after which a model with a medium effect size was developed for 1-year perceived recovery only. Consequently, patients with derangement syndrome were expected to have improved 1-year perceived recovery, with expected predetermined prognostic factors including shorter symptom duration, self-management skills to lead a healthy life, and less pain catastrophization at baseline. A stronger therapeutic alliance between patient and therapist during the 1-month MDT intervention was identified as an expected modifiable prognostic factor. It may be difficult to accurately predict the annual absenteeism and personal expenses due to LBP given the weak to low effect sizes of the developed models.
这项多中心前瞻性队列研究旨在初步探讨在接受腰痛(LBP)机械诊断与治疗(MDT)的工人中,与1年感知恢复、缺勤率和个人费用相关的统计学上有意义的可改变和预先确定的因素。研究探索了三个逐步多元回归模型,包含42个自变量,其中包括:(1)社会人口学因素;(2)风险分层;(3)基线时以及1个月后的疼痛相关变量、心理变量和行为变量;(4)1个月随访时的治疗联盟和运动依从性;(5)MDT分类和治疗师水平。对58名参与者的数据进行了分析,之后仅针对1年感知恢复建立了一个中等效应量的模型。因此,紊乱综合征患者预计1年感知恢复情况会有所改善,预期的预先确定的预后因素包括症状持续时间较短、拥有健康生活的自我管理技能以及基线时较少的疼痛灾难化。在1个月的MDT干预期间,患者与治疗师之间更强的治疗联盟被确定为一个预期的可改变的预后因素。鉴于所建立模型的效应量较弱至较低,可能难以准确预测因腰痛导致的年度缺勤率和个人费用。