The relationship between change in function and change in psychosocial parameters in individuals with chronic low back pain.
Dr. Cormac Ryan Dr. William MacLaren Prof. Malcolm Granat
Glasgow Caledonian School of Health and Social Care, and School of Engineering and Computing
Introduction: Change in psychosocial parameters is associated with change in self-reported function in individuals with chronic low back pain (CLBP). It has not been shown if changes in these psychosocial parameters are associated with changes in objective measures of functioning. Aim: To investigate the relationship between change in psychological parameters and change in subjective and objective functional measures in individuals with CLBP. Method: Function and psychosocial measures were assessed pre and post an intervention for individuals with CLBP (n=31). The psychological variables were collected using standardised questionnaires; Pain self-efficacy scale, Modified Zung depression index, Modified somatic perceptions questionnaire, the Tampa scale of Kinesiophobia fear and harm subscales, and a Pain numerical rating scale. Function was measured using self-report (The Roland Morris Disability Questionnaire) and estimated energy expenditure measured using the activPAL™ activity monitor. Two stepwise regression analyses were used to assess the relationship between change in both function markers and psychosocial variables. Ethical approval was obtained for this study. Results: The greater the improvement in pain self-efficacy and depression the greater the improvement in self-reported function (p<0.05). There was a direct relationship between change in fear of harm and energy expenditure (p=0.01), however, the direction of the relationship was counterintuitive with greater improvements in fear or harm associated with a smaller increase in EE. Conclusion: Changes in psychosocial variables were associated with changes in subjective and objective markers of functioning in individuals with CLBP. The direction of the relationship depended on the functional measure used.
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