Determining predictive outcome factors for a multimodal treatment program in low back pain patients : a retrospective cohort study

Objective: The purpose of this study was to determine the factors predictive of outcomes in a multifaceted rehabilitation program for acute and chronic low back pain (LBP) patients. Methods: A retrospective cohort study was performed on 565 LBP patients (153 acute and 412 chronic) who participated in a multimodal treatment program at an outpatient clinic in Belgium between 2007 and 2010. The predictive value of several factors, including age, sex, body mass index, fat percentage, Oswestry Disability Index score, Beck Depression Index score, Numeric Pain Rating Scale score for back and leg pain intensity, and Tampa Scale for Kinesiophobia score on favorable treatment outcomes was examined using logistic regression analysis. Results: The results from the multivariate regression indicated that a higher score on the Tampa Scale for Kinesiophobia (odds ratio [OR] = 0.92) decreases the odds of a favorable outcome following a multimodal treatment program in acute LBP. Older age (OR = 0.97), lowLBP intensity (OR = 1.191), and higher scores on the Beck Depression Index (OR= 0.96) and the Oswestry LBP Disability Index (OR = 0.93) decreased the odds of a favorable treatment outcome in chronic LBP. Conclusions: The findings of this study indicate that factors predictive of a (un) favorable treatment outcome differ between acute and chronic LBP. Specifically, kinesiophobia is predictive of poor treatment outcome in acute LBP. In chronic LBP, older age, low LBP intensity, and higher degrees of depression and LBP-related disability are predictive of poor treatment outcome. Therapists should consider assessing these predictive factors at intake to tailor the content of the multimodal treatment program to individual patient needs