Predictors of low back disability in chiropractic and physical therapy settings

M. John Petrozzi*, Sidney M. Rubinstein, Paulo H. Ferreira, Andrew Leaver, Martin G. Mackey

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background: Predicting ongoing disability for chronic non-specific low back pain (LBP) is important to avoid prolonged disability. Objective: Determine predictors of disability at 6 month follow-up in patients with LBP at medium risk of ongoing disability. Methods: Baseline data was collected from 108 patients with medium-risk chronic non-specific LBP (mean age 50.4 years, SD 13.6) from six private chiropractic and physiotherapy clinics in Australia who took part in a randomised control trial. All patients received a pragmatic course of multimodal physical treatments [e.g., manual therapy (spinal manipulation or mobilization and/or soft tissue massage)] combined with advice, education and exercise. Baseline prognostic variables included sociodemographic, physical and psychological characteristics. Primary outcome was disability (Roland Morris Disability) at 6 month follow-up. Multivariable linear regression analysis was conducted. Results: Variables remaining in the final multivariable model: lower work ability (β = - 1.05, 95% CI - 1.40 to - 0.70; p < 0.0001) and consultation with a medical specialist for back pain in the preceding 3 months (β = 3.35, 95% CI 1.14 to 5.55; p < 0.003), which significantly predicted higher disability at 6 months (unadjusted R 2 = 0.31). Those with a lower work ability (scale 1 to 10) and who had seen a medical specialist for their back pain were more likely to report greater LBP-related disability at 6 months. Conclusion: Patients with chronic LBP presenting to primary care with lower work ability and recent consultation with a medical specialist for LBP are more likely to have a worse prognosis; these are indicators to clinicians that standard conservative care may not adequately manage the patients' needs.

Original languageEnglish
Article number41
Pages (from-to)1-9
Number of pages9
JournalChiropractic and Manual Therapies
Issue number1
Publication statusPublished - 12 Aug 2020


  • Chiropractic
  • Chronic non-specific LBP
  • Physical therapy
  • Predictors
  • Prognosis


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