Acute Low Back Pain Screening Research Articles

Prevalence of acute low back pain with risk of long-term disability and its correlates among medical students: A cross-sectional study.

Low back pain (LBP) is responsible for the highest number of years lived with disability globally. There is a paucity of data regarding the same among medical students. So, this study was planned to estimate the prevalence of acute LBP having a high propensity to develop into chronic one as well as to determine associated correlates among medical students. This cross-sectional study was conducted among 300 medical students at a tertiary hospital using an Acute Low Back Pain Screening Questionnaire (ALBPSQ) to identify individuals with LBP and having a high risk of developing a long-term disability. ALBPSQ is a 21-question-based biopsychosocial screening instrument for identifying patients at risk of chronicity. ALBPSQ scores have been found to be significantly associated with pain and functional disability. Descriptive statistics, bivariate analysis, and multiple binary logistic regression have been performed through SPSS-22 software. The prevalence of LBP having the propensity to develop into a long-term disability was found to be 14.3% (95% CI: 10.6-18.8). In bivariate analysis, higher age, no exercise, higher screen time, mental stress, studying in bed, abnormal posture, alcohol intake, tobacco use, positive family history, greater screen time per day, and more time spent in a sitting posture are significant with LBP. Stress ((adjusted odds ratio) AOR: 4.37, 95% CI: 1.79-10.68)), abnormally bent standing posture (AOR: 3.6, 95% CI: 1.3-10.6), and positive family of LBP (AOR: 3.6, 95% CI: 1.3-10.1) were found to be independent predictors of LBP among medical students. Among medical students, every 15 out of 100 have a low back problem with chances of long-term disability. These students require early intervention to avoid long-term disability. Abnormal stooping posture, psychological stress, and positive family history of low pain might independently lead to LBP.

The Relationship Between Sedentary Behavior, Back Pain, and Psychosocial Correlates Among University Employees.

Objectives: This study aims to investigate the relationship between levels of sedentary behavior, physical activity, and back pain and their psychosocial correlates among university employees.Methods: A cross-sectional study was conducted on both academic and non-academic professional staff at Qatar University. The data collection instrument was a combination of the International Physical Activity Questionnaire (IPAQ), the Global Physical Activity Questionnaire (GPAQ) and the Acute Low Back Pain Screening Questionnaire (ALBPSQ).Results: A total of 479 individuals (57% females) participated in the cross-sectional study. Two hundred and ninety three (61.2%) reported to have experienced back pain. The covariates adjusted odds ratios (aORs) showed that vigorous physical activity was a protective variable for those who experienced lower back pain [aOR = 0.84, 95%CI (0.56–0.98)], both lower and upper back pain [aOR = 0.61, 95% CI (0.33–0.87)] and either lower or upper back pain [aOR = 0.76, 95%CI (0.51–0.85)], respectively. Back pain was significantly higher in females than males (aORs: 1.37–2.21). Similarly, sedentary behavior (too much sitting) was significantly associated with those who experienced either LBP or UBP [aOR = 1.74, 95% CI (1.19, 2.57)]. All back pain categories were found to be significantly associated with those who reported a depressed mood.Conclusions: These findings suggest that sedentary employees are exposed to increasing occupational hazards such as back pain and mental health issues. Strategies should aim to reduce sitting time with planned and feasible physical activity interventions to be incorporated into the workplace health promotion policy to help prevent back pain, back injuries, and mental health complications.

Measuring Psychosocial Variables in Patients With (Sub) Acute Low Back Pain Complaints, at Risk for Chronicity

A validation study of the Acute Low Back Pain Screening Questionnaire Dutch Language Version (ALBPSQ-DLV). To determine internal consistency, construct and convergent validity of the ALBPSQ-DLV in a population of patients with (sub) acute low back pain (LBP) referred to primary care physical therapy in The Netherlands. Viewing LBP as a multifactorial biopsychosocial syndrome enhances the need for validating instruments for screening psychosocial variables in patients with LBP. The ALBPSQ has been specifically constructed as a self-administered screening instrument, based on variables that have been suggested as a risk factor in the literature. A total of 69 patients with (sub) acute LBP were recruited. Internal consistency of the ALBPSQ-DLV was determined by calculating Cronbach alpha. Construct validity was determined by applying exploratory factor analysis. Convergent validity was assessed by calculating Pearson's correlation coefficients between domains of ALBPSQ-DLV and Dutch language versions of the Fear Avoidance Beliefs Questionnaire, Tampa Scale for Kinesiophobia, Pain Coping Inventory, Quebec Back Pain Disability Scale, and the Visual Analogue Scale of pain intensity. Internal consistency of the ALBPSQ-DLV was 0.81. Values of the various subscales ranged between 0.48 and 0.88. Convergent validity was confirmed by moderate to good correlation coefficients (P = 0.01) between the scores on the subscales and the constructs of pain, disability, fear-avoidance beliefs, kinesiophobia, and coping (r = 0.38-0.64). Exploratory factor analysis, suppressing absolute values less than 0.40, revealed components which were in agreement with the various domains of the original ALBPSQ. The internal consistency and both construct and convergent validity of the ALBPSQ-DLV are well established in a Dutch population of 69 patients with (sub) acute nonspecific LBP referred to primary care physical therapy.

The Ability of the Acute Low Back Pain Screening Questionnaire to Predict Sick Leave in Patients With Acute Neck Pain

Objective The aim of this study was to investigate the use of the Acute Low Back Pain Screening Questionnaire (ALBPSQ) in patients with acute neck pain in general practice. The ALBPSQ is a biopsychosocial screening questionnaire containing 20 items concerning mainly psychosocial variables. Although originally developed for patients with low back pain, it may also be applicable for patients with neck pain. We evaluated its reliability and determined an optimal cutoff point for predicting future sick leave. Methods A prospective study was conducted on consecutive patients with acute neck pain in general practice with a follow-up period of 1 year. Reliability was determined by means of a test-retest procedure with a 1-week interval. The total number of days on sick leave was added up based on self-reported questionnaires. Results One hundred eighty-seven patients were included in the study, of which 180 patients were included in the analysis. Almost half of the patients were better or much improved within the first week. Test-retest reliability was high (intraclass correlation coefficient, 0.85; 95% confidence interval, 0.73-0.92). Almost 40% of the patients reported sick leave because of neck pain during the follow-up period. An optimal cutoff score of 72 was calculated for predicting future sick leave, with a sensitivity of 77% and a specificity of 62%. The area under the curve of the receiver operator characteristics curve was regarded doubtful (0.66; 95% confidence interval, 0.56-0.76). Conclusion The ALBPSQ has shown to be a reliable instrument and potentially useful in a screening procedure for future sick leave in patients with acute neck pain in general practice.

Evaluation of functional results according to Body Mass Index in patients with acute non-specific low back pain

Objective: The aim of our study was to detect the factors which might affect the recovery of the patients with Acute Non-Specific Low Back Pain (ANSLBP) according to their Body Mass Index (BMI), and to determine the effects of these factors on disability and the perceived functional level with quality of life. Design: A retrospective study. Patients: Ninety-three patients were included in the study, and separated as three groups according to BMI (normal weight group, Grade1 obesity group, Grade 2 obesity group). Methods: Acute Low Back Pain Screening Questionnaire (ALBPSQ) and SF-36 Physical Functioning Scale (PFS) were used in the evaluation of the patients. Results: The ALBPSQ and SF-36 PFS results of our patients in all three groups before and after the treatment were found to be significant in the direction of positive scores ( p< 0.05). When the SF-36 PFS scores and the total scores of ALBPSQ were compared among the groups according to the increase of the obesity, there existed a significant difference ( p< 0.05). Between the ALBPSQ and SF-36 PFS scores, in the three groups correlation was determined in the negative direction. Conclusion: With the treatment applied to our patients, pain and disability with the quality of life showed positive differences, but the results were observed to be affected unfavorably through the increase of obesity based on the functional status and decrease in the quality of life.

Psychosocial Variables in Patients With (Sub)Acute Low Back Pain

A prospective cohort study of patients with episodes of acute or subacute low back pain, seeking physical therapy in primary care, with follow-up at weeks 2, 4, 8, and 12. To evaluate the association between psychosocial factors and the transition from acute or subacute low back pain to chronicity. Psychosocial factors have long been thought to be associated with chronic pain only. Recent prospective studies, however, suggest that these factors may also be important in acute or subacute low back pain. Demographic, psychosocial, and psychological baseline data were collected and analyzed from a sample of 66 acute or subacute patients with low back pain in order to predict the 3-month outcome. After 3 months, response rate was 85% (56 patients). Forty-five percent rated their current status as "not recovered." Twelve percent reported work absenteeism. Using multiple regression analyses, baseline scores on the Acute Low Back Pain Screening Questionnaire, Pain Coping Inventory, Fear-Avoidance Beliefs Questionnaire, and Tampa Scale for Kinesiophobia were not significantly associated with non-recovery at 3 months. The only significant predictor at baseline was the subscale pain of the ALBPSQ, correctly classifying 80% of the patients. The relative risk for not being recovered was 3.72 (95% confidence interval, 1.63-8.52) for the subjects with high scores on the subscale for pain. Pain scores and scores on psychosocial variables at 12 weeks were not associated. The study strongly revealed pain-related items to be essential factors in the development of chronicity and long-term disability in primary care physical therapy. Health status at 8 weeks seems crucial in developing chronicity.

Screening for Yellow Flags in First-time Acute Low Back Pain: Reliability and Validity of a Norwegian Version of the Acute Low Back Pain Screening Questionnaire

The purpose of this study was to evaluate the reliability and construct and predictive validity of the Norwegian version of the Acute Low Back Pain Screening Questionnnaire (ALBPSQ). A prospective study with a 12-month follow-up was conducted on 123 patients with acute low back pain (LBP) seeking help in primary health care for the first time and 50 patients with chronic LBP for more than 3 months. Test-retest reliability was high with intraclass correlation coefficients of 0.90, minimal detectable change of 12 points (of a total score of 210), and coefficient of variation of 4%. Internal consistency was 0.95. Principal-components analysis revealed 3 factors explaining 49% of the variance. The ALBPSQ score correlated highly (r> or =0.60) with disability variables, moderately (0.30<r<0.60) with age, pain intensity, and psychologic, questionnaires, and weakly (r< or =0.30) with most sociodemographic and clinical variables. The ALBPSQ were significantly lower in acute compared with chronic LBP at all follow-up visits (P<0.001). Significant associations were found between high-risk and low-risk subgroups on the ALBPSQ and pain and disability variables during follow-up. Different cut-off points on the accuracy of predicting outcomes at 6 and 12 months' follow-up showed high specificity and low sensitivity with a best cut-off of 90 points. The findings of this study provide further evidence of the utility of the ALBPSQ in clinical studies and in primary care settings (general practitioners, chiropractors, and physiotherapists) to help identify patients at risk of developing chronic LBP and disability.

Prognostic factors in first-time care seekers due to acute low back pain

There is limited knowledge on prognostic factors for developing chronic low back pain (LBP) at an early stage of LBP. The objectives of this study were to investigate the clinical course of pain and disability, and prognostic factors for non-recovery after 1-year, in patients seeking help for the first time due to acute LBP. An inception cohort study included 123 patients with acute LBP lasting less than 3 weeks and consulting primary care for the first time. Main outcome measures were pain intensity, Roland–Morris disability questionnaire (RMQ), and sickness absence. Eleven patients (9%) did not return for the 12-month follow-up. There were large and significant reductions in pain intensity ( P < 0.001) and RMQ scores ( P < 0.001) during follow-up. Patients with neurological signs showed significantly less improvement in pain ( P = 0.001) and RMQ ( P = 0.004) compared with those without neurological signs. The proportions with sickness absence due to LBP at 6, 9, and 12 months were 7%, 8%, and 9%, respectively. At 12 months, 17% of patients had not fully recovered. Multivariate logistic regression analyses showed that high scores on a psychosocial screening (acute low back pain screening questionnaire) and emotional distress (Hopkin’s symptom check list) were significantly associated with non-recovery at 12 months, with odds ratios of 4.4 (95% confidence interval 1.1–17.4) and 3.3 (1.1–10.2), respectively.

Biopsychosocial screening questionnaire for patients with low back pain: preliminary report of utility in physiotherapy practice in Northern Ireland. (University of Ulster, Jordanstown, Northern Ireland) Clin J Pain 2000;16:214–228.

This study aimed to investigate the potential utility of a new biopsychosocial‐screening questionnaire by exploring the relationship between it and several physical risk factors and posttreatment outcomes. The relationship between the screening questionnaire and valid and reliable outcome measures of pain and functional disability was also compared. Significant associations were detected between questionnaire scores and pretreatment “leisure time exercise,”“analgesic medication use,” and “subjective anesthesia;” posttreatment “return to work;”and “number of physiotherapy treatments” as well as pain and functional disability measures. A cutoff “at risk” sore of 112 was calculated, which correctly classified 74% of the patients who received six treatments and 80% of the patients who failed to return to work at the end of the treatment. The findings of this study provide preliminary evidence of the utility of this biopsychosocial screening questionnaire for future use in clinical intervention studies in the Northern Ireland National Health Service. Further comparative investigations in other health care settings are warranted.Comment by Phillip S. Sizer Jr., MEd, P.T. The investigators presented a study aimed at evaluating the utility of the Acute Low Back Pain Screening Questionnaire (ALBPSQ) in patients with LBP in the Northern Ireland NHS. A cut‐off score for the questionnaire was established by examining the relationship between the questionnaire and several documented risk factors, as well as validated treatment outcome measures for pain and functional disability. This cross‐sectional and longitudinal design was based on a thorough evaluation of the literature regarding risk factors for the development of LBP chronicity. A total of 118 patients (47 male, 71 female; mean age of 43.19 years) participated. The questionnaire was comprised of 24 items divided into the following groups: function, pain, psychological factors, fear avoidance, and miscellaneous (sick leave, age, gender, nationality, monotonous versus heavy work, and job satisfaction). Pain was measured with the McGill Pain Questionnaire (MPQ) and pain‐specific functional disability was measured with the Roland Morris Disability Questionnaire (RMDQ). These measures were conducted before and after treatment, which included advice, education, exercise, manipulative therapy, electrotherapy, traction and thermal agents. The ALBPSQ was significantly correlated with three pretreatment variables (leisure time exercise, subjective anesthesia, and analgesic medication) and two posttreatment variables (Return to work and number of physiotherapy treatments). Additionally, the investigators suggested an ALBPSQ cutoff score of 112, although they supported the idea that the screening tool is not 100% accurate. They also found that a score of 112 was significantly associated with the MPQ and RMDQ scores. Furthermore, they observed no significant differences in ALBPSQ scores from working versus nonworking individuals. The authors noted the limitations of this investigation, which included the lack of a control group, inconsistent treatment strategies, and the absence of evaluating the impact of litigation on score outcomes. With these limitations in mind, the ALBPSQ may prove to be a useful tool in both research and clinical practice for predicting risk for chronicity. Future research should include a similar investigation in the United States, considering potential differences in the two health care delivery systems, as well as respective patterns of managing worker's compensation.

Biopsychosocial screening questionnaire for patients with low back pain: preliminary report of utility in physiotherapy practice in Northern Ireland.

The aim of this study was to investigate the potential utility of a new biopsychosocial screening questionnaire (Acute Low Back Pain Screening Questionnaire) by exploring the relation between it and several physical risk factors and posttreatment outcomes so as to establish a cutoff point for the local population. The relation between the screening questionnaire and valid and reliable outcome measures of pain and functional disability was also explored. Cross-sectional and longitudinal studies were conducted on patients referred for physiotherapy for low back pain to a large Healthcare Trust in Northern Ireland. Before initial assessment, patients completed the screening questionnaire and outcome measures, were questioned about known physical risk factors, and then received physiotherapy. At final discharge, the outcome variables--the "number of treatments" and patient's current work status ("return to work [yes/no]")--were recorded, and patients recompleted the outcome measures. One hundred eighteen patients gave written informed consent to participate in this study. Significant associations were detected between questionnaire scores and pretreatment "leisure time exercise," "analgesic medication use," and "subjective anesthesia"; posttreatment "return to work"; and "number of physiotherapy treatments" as well as pain and functional disability measures. A cutoff "at-risk" score of 112 was calculated, which correctly classified 74% of patients who received more than six treatments and 80% of patients who failed to return to work at the end of treatment. The findings of this study provide preliminary evidence of the utility of this biopsychosocial screening questionnaire for future use in clinical intervention studies in the Northern Ireland National Health Service. Further comparative investigations in other health care settings are warranted.