Discussion : While pain intensity and long-term chronicity did not predict physical functioning in chronic pain patients after MDR , poor pretreatment physical and psychological functioning influenced the prognosis negatively .
Thus , treatment should further target and optimize these modifiable factors and an increased focus on positive , psychological protective factors may perhaps provide an opening for yet untapped clinical gains
Objectives : This systematic review aim ed to identify and evaluate prognostic factors for long-term ( ≥6 mo ) physical functioning in patients with chronic musculoskeletal pain following multidisciplinary rehabilitation ( MDR ) .
Prognosis and Course of Disability in Patients With Chronic Nonspecific Low Back Pain: A 5- and 12-Month Follow-up Cohort Study
Background Few data are available on the course of and predictors for disability in patients with chronic nonspecific low back pain ( CNSLBP ) . Objective The purpose of this study was to describe the course of disability and identify clinical ly important prognostic factors of low-back-pain – specific disability in patients with CNSLBP receiving multidisciplinary therapy .  Design A prospect i ve cohort study was conducted . Methods A total of 1,760 patients with CNSLBP who received multidisciplinary therapy  were evaluated for their course of disability and prognostic factors at baseline and at 2- , 5- , and 12-month follow-ups . Recovery was defined as 30 % reduction in low back pain – specific disability at follow-up compared with baseline and as absolute recovery if the score on the Quebec Back Pain Disability Scale ( QBPDS ) was ≤20 points at follow-up . Potential prognostic factors were identified using multivariable logistic regression analysis . Results Mean patient-reported disability scores on the QBPDS ranged from 51.7 ( SD=15.6 ) at baseline to 31.7 ( SD=15.2 ) , 31.1 ( SD=18.2 ) , and 29.1 ( SD=20.0 ) at 2 , 5 , and 12 months , respectively . The prognostic factors identified for recovery at 5 and 12 months were younger age and high scores on disability and on the 36-Item Short-Form Health Survey ( SF-36 ) ( Physical and Mental Component Summaries ) at baseline . In addition , at 5-month follow-up , a shorter duration of complaints was a positive predictor , and having no comorbidity and less pain at baseline were additional predictors at 12-month follow-up . Limitations Missing values at 5- and 12-month follow-ups were 11.1 % and 45.2 % , respectively . Conclusion After multidisciplinary treatment , the course of disability in patients with CNSLBP continued to decline over a 12-month period . At 5- and 12-month follow-ups , prognostic factors were identified for a clinical ly relevant decrease in disability scores on the QBPDS
Discussion : While pain intensity and long-term chronicity did not predict physical functioning in chronic pain patients after MDR , poor pretreatment physical and psychological functioning influenced the prognosis negatively .
Thus , treatment should further target and optimize these modifiable factors and an increased focus on positive , psychological protective factors may perhaps provide an opening for yet untapped clinical gains
Objectives : This systematic review aim ed to identify and evaluate prognostic factors for long-term ( ≥6 mo ) physical functioning in patients with chronic musculoskeletal pain following multidisciplinary rehabilitation ( MDR ) .