Abstract
Introduction Prognostic screening of people with low back pain (LBP) improves utilisation of primary healthcare resources. Whether this also applies to secondary healthcare remains unclear. Therefore, this study aims to develop prognostic models to determine at baseline which patients with persistent LBP are likely to have a good and poor outcome to a 5-week programme of combined education and exercise ('UPLIFT') delivered in a secondary healthcare setting. Methods and analysis A prospective cohort study of 246 people with persistent LBP will be conducted in a secondary healthcare outpatient setting. Patients will be recruited from a physiotherapy-led neurosurgical screening clinic. Demographic data, medical history and psychosocial characteristics will be recorded at baseline. Fear avoidance beliefs, pain self-efficacy, LBP treatment beliefs, pain catastrophising, perceived injustice, depression, anxiety and stress, disability level, pain intensity and interference, health status and social connectedness will be considered as potential prognostic variables, which will be assessed using self-reported questionnaires. Participants will attend the UPLIFT programme, consisting of weekly 90 min group sessions that combine interactive education sessions and a graded exercise programme. The outcome measure to identify good and poor outcome is the Global Rating of Change scale, assessed at completion of the UPLIFT programme and at 6 months follow-up. Multiple imputation analyses will be performed for missing values. Prognostic models will be developed using multivariable logistic regression analyses, with bootstrapping techniques for internal validation. We will calculate the explained variance of the models and the area under the receiver operating characteristic curve. Furthermore, we will determine whether participation in the UPLIFT programme is associated with changes in psychosocial characteristics. Ethics and dissemination Gold Coast Health Service Human Research Ethics Committee (HREC/18/QGC/41) and the Griffith University Human Research Ethics Committee (GU Ref No: 2018/408) approved the study. Dissemination of findings will occur via peer-reviewed publications and conference presentations. Trial registration number ACTRN12618001525279.
Original language | English |
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Article number | e028747 |
Pages (from-to) | 1-10 |
Number of pages | 10 |
Journal | BMJ Open |
Volume | 9 |
Issue number | 8 |
DOIs | |
Publication status | Published - 10 Aug 2019 |
Funding
Funding This work is supported by Gold Coast Hospital and Health Service and Gold Coast Hospital Foundation grant number SG0027.
Funders | Funder number |
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Gold Coast Hospital Foundation | SG0027 |
Gold Coast Hospital and Health Service | |
Gold Coast Hospital and Health Service and Gold Coast Hospital Foundation |
Keywords
- biopsychosocial
- chronic pain
- disability
- pain education
- prognosis
- rehabilitation