Dataset Information

Validity of a Paradigm for Low Back Pain Symptom Development During Prolonged Standing.

ABSTRACT: Examine the validity of an induced pain paradigm in which people stand while performing simulated light work tasks (standing paradigm).Initially, people with low back pain (LBP) reported the quality and location of their typical symptoms on a body pain diagram. Then, people with LBP and back-healthy people stood for 2 hours and reported the intensity, quality, and location of symptoms at baseline and every 15 minutes. Quality and location of typical symptoms of people with LBP were compared with their symptoms during standing. Back-healthy people were separated into pain developers (PDs) and nonpain developers. Symptom quality and location were compared between people with LBP and PDs.There were no differences in the quality and location of typical symptoms and symptoms during standing in people with LBP (P>0.05). Three symptom descriptors were used by >30% of people with LBP to describe typical symptoms. Only 2 people with LBP used these descriptors to describe typical symptoms but not during standing. There were no differences in the quality and location of symptoms reported in standing between people with LBP and PDs (P>0.05). Four symptom descriptors were used by >30% of participants with LBP during standing. There were no symptoms reported by PDs that were not reported by people with LBP.This study provides evidence that symptoms experienced during the standing paradigm are similar to symptoms experienced by people with LBP and, thus, provides support for the validity of the paradigm.

SUBMITTER: Sorensen CJ

PROVIDER: S-EPMC4344929 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Validity of a Paradigm for Low Back Pain Symptom Development During Prolonged Standing.

Sorensen Christopher J CJ Johnson Molly B MB Callaghan Jack P JP George Steven Z SZ Van Dillen Linda R LR

The Clinical journal of pain 20150701 7

<h4>Objectives</h4>Examine the validity of an induced pain paradigm in which people stand while performing simulated light work tasks (standing paradigm).<h4>Materials and methods</h4>Initially, people with low back pain (LBP) reported the quality and location of their typical symptoms on a body pain diagram. Then, people with LBP and back-healthy people stood for 2 hours and reported the intensity, quality, and location of symptoms at baseline and every 15 minutes. Quality and location of typic ...[more]

PMID: 25171636

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Project description:Pain developers (PDs) are considered a pre-clinical low back pain (LBP) population at risk of clinical LBP development and thus exacting great social and economic costs. Therefore, it is necessary to comprehensively investigate their distinctive characteristics and the risk factors of standing-induced LBP based on which appropriate preventive measures can be planned. Scopus, Web of Science, and PubMed databases as well as Google Scholar and ProQuest were systematically searched from inception through 14 July 2022 using a combination of terms relevant to 'standing' and 'LBP'. Studies with low risk of bias in English and Persian using a methodological quality scoring system were deemed eligible for inclusion if they were laboratory studies using prolonged standing duration greater than 42 min to classify adult PDs and non-pain developers (NPDs) without a history of LBP. PDs were compared with NPDs in demographics, biomechanical, and psychological outcomes. Weighted or standardized mean differences, and Hedge's g were generated to determine the pooled effect sizes using STATA software version 17. 52 papers and theses involving 1070 participants (528 PDs and 542 NPDs) were eligible for inclusion in the systematic review 33 of which were used in meta-analyses. Significant differences between PDs and NPDs in terms of movement patterns, muscular, postural, psychological, structural, and anthropometric variables were evidenced. The following factors were found to have a statistically significant association with standing-induced LBP: lumbar fidgets (Hedge's g - 0.72, 95% CI - 1.35 to - 0.08, P = 0.03), lumbar lordosis in participants over 25 years (Hedge's g 2.75, 95% CI 1.89-3.61, P < 0.001), AHAbd test (WMD 0.7, 95% CI 0.36-1.05, P < 0.001), GMed co-activation (Hedge's g 4.24, 95% CI 3.18-5.3, P < 0.001), and Pain Catastrophizing Scale (WMD 2.85, 95% CI 0.51-5.19, P = 0.02). Altered motor control displayed in AHAbd test and higher lumbar lordosis in individuals over 25 years seem to be probable risk factors for standing-induced LBP. In order to detect standing-induced LBP risk factors, future researchers should investigate the association of the reported distinctive characteristics to the standing-induced LBP and that whether they are manipulable through various interventions.

Project description:BACKGROUND CONTEXT:The US National Pain Strategy focused attention on high-impact chronic pain and its restrictions. Although many interventions have been studied for chronic low-back pain, results are typically reported for heterogeneous samples. To better understand chronic pain and target interventions to those who most need care, more granular classifications recognizing chronic pain's impact are needed. PURPOSE:To test whether chronic pain impact levels can be identified in chronic low-back pain clinical trial samples, examine the baseline patient mix across studies, and evaluate the construct validity of high-impact chronic pain. STUDY DESIGN/SETTING:Descriptive analyses using 12 large study datasets. PATIENT SAMPLES:Chronic low-back pain patients in nonsurgical, nonpharmacologic trials in the US, Canada, and UK. OUTCOME MEASURES:Preference-based health utilities from the SF-6D and EQ-5D, employment status and absenteeism. METHODS:We used two logistic regression models to predict whether patients had high-impact chronic pain and whether the remainder had low- or moderate-impact chronic pain. We developed these models using two datasets. Models with the best predictive power were used to impute impact levels for six other datasets. Stratified by these estimated chronic pain impact levels, we characterized the case mix of patients at baseline in each dataset, and summarized their health-utilities and work productivity. This study was funded by a National Center for Complementary and Integrative Medicine grant. The authors have no potential conflicts of interest. RESULTS:The logistic models had excellent predictive power to identify those with high-impact chronic pain. Although studies were all of chronic low-back pain patients, the baseline mix of patients varied widely. Across all datasets, utilities, and productivity were similar for those with high-impact chronic pain and worsened as chronic pain impact increased. CONCLUSIONS:There is a need to better categorize chronic pain patients to allow the targeting of optimal interventions for those with each level of chronic pain impact.

Dataset Information

Validity of a Paradigm for Low Back Pain Symptom Development During Prolonged Standing.

Publications

Validity of a Paradigm for Low Back Pain Symptom Development During Prolonged Standing.

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