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

Objectives: To determine the predictive outcome factors for a multifaceted rehabilitation program among acute and chronic low back pain (LBP) patients. Methods: A retrospective cohort study was performed on 565 (153 acute and 412 chronic) LBP patients who participated in a multimodal treatment program at an outpatient clinic in Belgium between 2007 to 2010. The predictive value of several factors including age, gender, body mass index, fat percentage, Oswestry Disability Index score, Beck Depression Index score, Numeric Rating Scale score for back and leg pain intensity, and Tampa Scale for Kinesiophobia score on favorable treatment outcome was examined using logistic regression analysis. Results: The results from the multivariate regression indicated that a higher score on the Tampa Scale for Kinesiophobia (OR=0.92) decreases the odds of a favorable outcome following a multimodal treatment program in acute LBP. Older age (OR=0.97), high LBP 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 for a favorable treatment outcome in chronic LBP. Conclusions: The findings of this study indicate that predictive factors for (un)favorable treatment outcome differ between acute and chronic LBP. Specifically, the presence of kinesiophobia is predictive for poor treatment outcome in acute LBP. In chronic LBP, older age, low LBP intensity, and higher degrees of depression and LBP related disability levels are predictive for poor treatment outcome. Therefore, therapists should assess these predictive factors at intake to optimize the content of the multimodal treatment program to individual patient needs