Psychological Features and Their Relationship to Movement-Based Subgroups in People Living With Low Back Pain

Abstract

Objective: To determine the distribution of higher psychological risk features within movement-based subgroups for people with low back pain (LBP).

Design: Cross-sectional observational study.

Setting: Participants were recruited from physiotherapy clinics and community advertisements. Measures were collected at a university outpatient-based physiotherapy clinic.

Participants: People (N=102) seeking treatment for LBP.

Interventions: Participants were subgrouped according to 3 classification schemes: Mechanical Diagnosis and Treatment (MDT), Treatment-Based Classification (TBC), and O'Sullivan Classification (OSC).

Main outcome measures: Questionnaires were used to categorize low-, medium-, and high-risk features based on depression, anxiety, and stress (Depression, Anxiety, and Stress Scale-21 Items); fear avoidance (Fear-Avoidance Beliefs Questionnaire); catastrophizing and coping (Pain-Related Self-Symptoms Scale); and self-efficacy (Pain Self-Efficacy Questionnaire). Psychological risk profiles were compared between movement-based subgroups within each scheme.

Results: Scores across all questionnaires revealed that most patients had low psychological risk profiles, but there were instances of higher (range, 1%-25%) risk profiles within questionnaire components. The small proportion of individuals with higher psychological risk scores were distributed between subgroups across TBC, MDT, and OSC schemes.

Conclusions: Movement-based subgrouping alone cannot inform on individuals with higher psychological risk features.

Keywords: Biopsychosocial; Low back pain; Rehabilitation; Subgrouping.