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BMC Musculoskeletal Disorders

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Open Access 01-12-2015 | Research article

Low back pain patients in Sweden, Denmark and the UK share similar characteristics and outcomes: a cross-national comparison of prospective cohort studies

Authors: Alice Kongsted, Laura Davies, Iben Axen

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

Abstract

Background

Low back pain (LBP) is the world’s leading cause of disability and yet poorly understood. Cross-national comparisons may motivate hypotheses about outcomes being condition-specific or related to cultural differences and can inform whether observations from one country may be generalised to another. This analysis of data from three cohort studies explored whether characteristics and outcomes differed between LBP patients visiting chiropractors in Sweden, Denmark and the UK.

Methods

LBP patients completed a baseline questionnaire and were followed up after 3, 5, 12 and 26 weeks. Outcomes were LBP intensity (0–10 scales) and LBP frequency (0–7 days the previous week). Cohort differences were tested in mixed models accounting for repeated measures. It was investigated if any differences were explained by different baseline characteristics, and interaction terms between baseline factors and nations tested if strength of prognostic factors differed across countries.

Results

The study sample consisted of 262, 947 and 453 patients from Sweden, Denmark and the UK respectively. Patient characteristics were largely similar across cohorts although some statistically significant differences were observed. The clinical course followed almost identical patterns across nations and small observed differences were not present after adjusting for baseline factors. The associations of LBP intensity and episode duration with outcome differed in strength between countries.

Conclusions

Chiropractic patients with low back pain had similar characteristics and clinical course across three Northern European countries. It is unlikely that culture have substantially different impacts on the course of LBP in these countries and the results support knowledge transfer between the investigated countries.

Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163–96.CrossRefPubMed

Hayden JA, Dunn KM, van der Windt DA, Shaw WS. What is the prognosis of back pain? Best Pract Res Clin Rheumatol. 2010;24(2):167–79.CrossRefPubMed

Kent PM, Keating JL. Can we predict poor recovery from recent-onset nonspecific low back pain? A systematic review. Man Ther. 2008;13(1):12–28.CrossRefPubMed

Verkerk K, Luijsterburg PA, Miedema HS, Pool-Goudzwaard A, Koes BW. Prognostic factors for recovery in chronic nonspecific low back pain: a systematic review. Phys Ther. 2012;92(9):1093–108.CrossRefPubMed

Da C, Menezes Costa L, Maher CG, Hancock MJ, McAuley JH, Herbert RD, et al. The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ. 2012;184(11):E613–24.CrossRef

Itz CJ, Geurts JW, Van Kleef M, Nelemans P. Clinical course of non-specific low back pain: a systematic review of prospective cohort studies set in primary care. Eur J Pain. 2013;17(1):5–15.CrossRefPubMed

Brookes ST, Whitely E, Egger M, Smith GD, Mulheran PA, Peters TJ. Subgroup analyses in randomized trials: risks of subgroup-specific analyses; power and sample size for the interaction test. J Clin Epidemiol. 2004;57(3):229–36.CrossRefPubMed

Axen I, Leboeuf-Yde C. Trajectories of low back pain. Best Pract Res Clin Rheumatol. 2013;27(5):601–12.CrossRefPubMed

Axen I, Bodin L, Bergstrom G, Halasz L, Lange F, Lovgren PW, et al. Clustering patients on the basis of their individual course of low back pain over a six month period. BMC Musculoskelet Disord. 2011;12:99.PubMedCentralCrossRefPubMed

10.

Kongsted A, Vach W, Axo M, Bech RN, Hestbaek L. Expectation of recovery from low back pain: a longitudinal cohort study investigating patient characteristics related to expectations and the association between expectations and 3-month outcome. Spine (Phila Pa 1976). 2014;39(1):81–90.CrossRef

11.

Eirikstoft H, Kongsted A. Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice. Man Ther. 2014;19(1):65–71.CrossRefPubMed

12.

Danish National Commitee on Biomedical Research Ethics. Guidelines about Notification. http://www.cvk.sum.dk/English/guidelinesaboutnotification.aspx

13.

Lemeunier N, Kongsted A, Axen I. Prevalence of pain-free weeks in chiropractic subjects with low back pain-a longitudinal study using data gathered with text messages. Chiropr Man Ther. 2011;19:28.CrossRef

14.

Intelligent Communication with SMS-Track [http://www.sms-track.com]

15.

Kongsted A, Leboeuf-Yde C. The Nordic back pain subpopulation program: course patterns established through weekly follow-ups in patients treated for low back pain. Chiropr Osteopat. 2010;18:2.PubMedCentralCrossRefPubMed

16.

Kongsted A, Kent P, Hestbaek L, Vach W. Patients with low back pain had distinct clinical course patterns that were typically neither complete recovery nor constant pain. A Latent Class Analysis of longitudinal data. Spine J. 2015;15(5):885–94.CrossRefPubMed

17.

Grotle M, Foster NE, Dunn KM, Croft P. Are prognostic indicators for poor outcome different for acute and chronic low back pain consulters in primary care? Pain. 2010;151(3):790–7.PubMedCentralCrossRefPubMed

18.

Nielsen OL, Kongsted A, Christensen HW. The Chiropractic Profession in Denmark 2010–2014. A descriptive report. 2015.

19.

Axen I, Rosenbaum A, Robech R, Wren T, Leboeuf-Yde C. Can patient reactions to the first chiropractic treatment predict early favorable treatment outcome in persistent low back pain? J Manipulative Physiol Ther. 2002;25(7):450–4.CrossRefPubMed

20.

Hestbaek L, Munck A, Hartvigsen L, Jarbol DE, Sondergaard J, Kongsted A. Low back pain in primary care: a description of 1250 patients with low back pain in danish general and chiropractic practice. Int J Family Med. 2014;2014:106102.PubMedCentralCrossRefPubMed

Title: Low back pain patients in Sweden, Denmark and the UK share similar characteristics and outcomes: a cross-national comparison of prospective cohort studies
Authors: Alice Kongsted
Laura Davies
Iben Axen
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-015-0824-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Low back pain patients in Sweden, Denmark and the UK share similar characteristics and outcomes: a cross-national comparison of prospective cohort studies

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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