Prognostic Factors for Recovery in Chronic Nonspecific Low Back Pain: A Systematic Review
Publication of Innovations in Care
H.S. Miedema, K. Verkerk, | Article | Publication date: 08 November 2011
Background. Few data are available on predictors for a favorable outcome in
patients with chronic nonspecific low back pain (CNLBP).
Purpose. The aim of this study was to assess prognostic factors for pain intensity,
disability, return to work, quality of life, and global perceived effect in patients with
CNLBP at short-term (6 months) and long-term (6 months) follow-up.
Data Sources. Relevant studies evaluating the prognosis of CNLBP were
searched in PubMed, CINAHL, and EMBASE (through March 2010).
Study Selection. Articles with all types of study designs were included. Inclusion
criteria were: participants were patients with CNLBP (12 weeks’ duration),
participants were older than 18 years of age, and the study was related to prognostic
factors for recovery. Fourteen studies met the inclusion criteria.
Data Extraction. Two reviewers extracted the data and details of each study.
Data Synthesis. A qualitative analysis using “level of evidence” was performed
for all included studies. Data were summarized in tables and critically appraised.
Limitations. The results of the studies reviewed were limited by their methodological
Conclusions. At short-term follow-up, no association was found for the factors of
age and sex with the outcomes of pain intensity and disability. At long-term follow-up,
smoking had the same result. At long-term follow-up, pain intensity and fear of
movement had no association with disability. At short-term follow-up, conflicting
evidence was found for the association between the outcomes pain intensity and
disability and the factor of fear of movement. At long-term follow-up, conflicting
evidence was found for the factors of age, sex, and physical job demands. At
long-term follow-up, conflicting evidence also was found for the association between
return to work and age, sex, and activities of daily living. At baseline, there was
limited evidence of a positive influence of lower pain intensity and physical job
demands on return to work. No high-quality studies were found for the outcomes of
quality of life and global perceived effect.