OBJECTIVES: To investigate if some demographic, psychological, and clinical variables can predict outcome with chiropractic care in patients with LBP.
METHOD: A prospective multi-center practice-based study was carried out, in which demographic, clinical and psychological information was collected at base-line. Outcome was established at the 4th visit and after three months. The predictive value was studied for all base-line variables, individually and in a multivariable analysis.
RESULTS: In all, 55 of 99 invited chiropractors collected information on 731 patients. At the 4th visit data were available on 626 patients and on 464 patients after 3 months. Fee subsidization (OR 3.2; 95% CI 1.9-5.5), total duration of pain in the past year (OR 1.5; 95% CI 1.0-2.2), and general health (OR 1.2; 95% CI 1.1-1.4) remained in the final model as predictors of treatment outcome at the 4th visit. The sensitivity was low (12%), whereas the specificity was high (97%). At the three months follow-up, duration of pain in the past year (OR 2.1; 95% CI 1.4-3.1), and pain in other parts of the spine in the past year (OR1.6; 1.1-2.5) were independently associated with outcome. However, both the sensitivity and specificity were relatively low (60% and 50%). The addition of the psychological variables did not improve the models and none of the psychological variables remained significant in the final analyses. There was a positive gradient in relation to the number of positive predictor variables and outcome, both at the 4th visit and after 3 months.
CONCLUSION: Psychological factors were not found to be relevant in the prediction of treatment outcome in Swedish chiropractic patients with LBP.
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