title: Prognostic factors and course for successful clinical outcome quality of life and patients' perceived effect after a cognitive behavior therapy for chronic non-specific low back pain: A 12-months prospective study.
abstract: This study investigates the clinical course of and prognostic factors for quality of life (Short Form 36 items Health survey (SF-36)) and global perceived effect (GPE) in patients treated for chronic non-specific low back pain at 5 and 12-months follow-up. Data from a prospective cohort (n = 1760) of a rehabilitation center were used, where patients followed a 2-months cognitive behavior treatment. The outcome 'improvement in quality of life (SF-36)' was defined as a 10% increase in score on the SF-36 at follow-up compared with baseline. On the GPE scale, patients who indicated to be 'much improved' were coded as 'clinically improved'. Multivariable logistic regression analysis included 23 baseline characteristics. At 5-months follow-up, scores on the SF-36 Mental Component Scale (SF-36; MCS) and the Physical Component Scale (SF-36; PCS) had increased from 46.6 (SD 10.3) to 50.4 (SD 9.8) and from 31.9 (SD 7.1) to 46.6 (SD 10.3), respectively. At 5-months follow-up, 53.0% of the patients reported clinical improvement (GPE) which increased to 60.3% at 12-months follow-up. The 10% improvement in quality of life (SF-36 MCS) at 5-months follow-up was associated with patient characteristics and psychological factors. At 5-months follow-up, the 10% improvement in quality of life (SF-36 PCS) and GPE was associated with patient characteristics, physical examination, work-related factors and psychological factors; for GPE, an association was also found with clinical status. At 12-months follow-up GPE was associated with patient characteristics, clinical status, physical examination and work-related factors. The next phase in this prognostic research is external validation of these results.
authors.affiliation: Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK Rotterdam, The Netherlands; Spine & Joint Centre, Rotterdam, The Netherlands; Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Electronic address: k.verkerk@hr.nl.
authors.forename: Karin
authors.initials: K
authors.lastname: Verkerk
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Pim A J
authors.initials: PA
authors.lastname: Luijsterburg
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Methodology and Applied Biostatistics, VU University, Institute for Health Sciences, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Martijn W
authors.initials: MW
authors.lastname: Heymans
authors.affiliation: Spine & Joint Centre, Rotterdam, The Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Ronchetti
authors.affiliation: Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK Rotterdam, The Netherlands.
authors.forename: Harald S
authors.initials: HS
authors.lastname: Miedema
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.affiliation: Department of Neuroscience, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Annelies
authors.initials: A
authors.lastname: Pool-Goudzwaard
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000523:psychology*; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Chronic non-specific low back pain; Course; Prognosis; Psychological factors