Abstract
Longitudinal quantitative measures of the natural course of low back pain. (Ohio State University, Columbus, OH) Spine 2000;25:1950–1956.This prospective study compared traditional self‐report measures of low back pain recovery with quantitative measure of recovery. Sixteen occupational and 16 non‐occupational patients with low back pain were recruited. Recovery was monitored prospectively every 2 weeks for 3 to 6 months, using subjective work status, pain symptoms, activities of daily living, and objective functional performance probability (trunk kinematics). Return to work underestimated the percentage of subjects impaired, as compared with all other outcome measures. Symptoms, activities of daily living, and functional performance probability all showed similar patterns of recovery for 0 to 12 weeks. At 14 weeks, there was a lag in functional performance recovery. Both symptoms and activities of daily living indicated that 80% of the population was recovered, whereas functional performance indicated the figure to be 68%. Conclude that the objective kinematic functional performance measure of recovery quantifies a different aspect of impairment not evaluated by traditional subjective measures. Use of several outcome measures may lead to a better understanding of low back pain recovery or residual impairment, which may minimize the risk of recurrent injury. Comment by Hemmo A. Bosscher, MD.This study evaluates several traditional and not so traditional quantitative measures in the recovery of low back pain. The authors hypothesize that a better understanding of the natural course of low back pain (LBP) recovery may provide the knowledge necessary to prevent high cost recurrent low back injuries. But the relationship between acute low back pain, its recovery, and the subsequent recurrence of LBP is not studied here at all. However the study offers some other interesting information. The traditional outcome measure “back to work” is a very insensitive one. It depends on the job rather than the severity of the LBP. A relatively new functional outcome measure was introduced: the lumbar motion monitor, a device that evaluates trunk kinematics. This measure seems more important in later stages of recovery.
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