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    Prognostic occupational factors for persistent low back pain in primary care

    Access Status
    Fulltext not available
    Authors
    Melloh, Markus
    Elfering, A.
    Chapple, C.
    Käser, A.
    Salathé, C.
    Barz, T.
    Röder, C.
    Theis, J.
    Date
    2013
    Type
    Journal Article
    
    Metadata
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    Citation
    Melloh, M. and Elfering, A. and Chapple, C. and Käser, A. and Salathé, C. and Barz, T. and Röder, C. et al. 2013. Prognostic occupational factors for persistent low back pain in primary care. International Archives of Occupational and Environmental Health. 86 (3): pp. 261-269.
    Source Title
    International Archives of Occupational and Environmental Health
    DOI
    10.1007/s00420-012-0761-9
    ISSN
    0340-0131
    School
    Curtin Medical School
    URI
    http://hdl.handle.net/20.500.11937/47249
    Collection
    • Curtin Research Publications
    Abstract

    Purpose: To reduce the socio-economic burden of persistent low back pain (LBP), factors influencing the progression of acute/subacute LBP to the persistent state must be identified at an early stage. Methods: Prospective inception cohort study of patients attending a health practitioner for their first episode of acute/subacute or recurrent LBP. Patients were assessed at baseline addressing occupational, psychological, biomedical and demographic/lifestyle factors and followed up over 6 months. Multivariate logistic regression analysis was performed separately for the variables groups of the four different domains, controlling for age, gender and body mass index. The overall predictive value was calculated for the full regression models of the different domains. Finally, all significant variables from the different domains were combined into a final predictor model. Results: The final four-predictor model predicted 51 % of variance of persistent LBP and included 'resigned attitude towards the job' (OR 1.73; 95 % CI 1.16-2.59), 'social support at work' (OR 0.54; 95 % CI 0.32-0.90), 'functional limitation' (OR 1.05; 95 % CI 1.01-1.10) and 'duration of LBP' (OR 1.04; 95 % CI 1.02-1.06). The accuracy of the model was 83 %, with 92 % of non-persistent and 67 % of persistent LBP patients correctly identified. Conclusions: In this study of patients with acute/subacute LBP, 'resigned attitude towards the job' increased the likelihood of persistent LBP at 6 month. Addressing this factor with workplace interventions has the potential to modify the outcome. In patients experiencing 'social support at work', the development of persistent LBP was less likely and might therefore be considered as potential resource for prevention of persistent LBP. © 2013 Springer-Verlag Berlin Heidelberg.

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