Trajectories of pain and disability in older adults with acute low back pain: Longitudinal data of the BACE-Brazil cohort

• Published in: Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Brazil)), 2022-01, Vol.26 (1), p.100386-100386, Article 100386
• Main Authors: Silva, Juscelio Pereira da, de Jesus-Moraleida, Fabianna Resende, Felício, Diogo Carvalho, Andrade, André Gustavo Pereira de, Pereira, Daniele Sirineu, Ferreira, Manuela Loureiro, Pereira, Leani Souza Máximo
• Format: Article
• Language: English
• Subjects: Acute Pain; Aged; Aging; Brazil; Clinical course; Disability Evaluation; Humans; Latent class growth analysis; Low Back Pain - therapy; Original Research; Prognosis; Prospective Studies; Rehabilitation; Surveys and Questionnaires
• ISSN: 1413-3555; 1809-9246
• DOI: 10.1016/j.bjpt.2021.100386

•The general course of acute low back pain does not reflect the aging heterogeneity.•Older adults with acute low back pain have varied pain and disability trajectories.•Complete recovery trajectories and persistent severe trajectories were identified.•Worse biopsychosocial health was associated with persistent severe trajectories.•Specific clinical care for different courses of low back pain can be implemented. Although the literature describes a favorable course of low back pain (LBP) in adults, little information is available for older adults. LBP is prevalent and complex in older adults, and the analysis of its trajectories may contribute to the improvement of therapeutic approaches. To describe pain and disability trajectories in older adults with a new episode of LBP. Older adults (n = 542), aged >55 years with a new episode of nonspecific LBP, were followed for 12 months in a prospective cohort. Pain intensity (Numeric Rating Scale) and disability (Roland-Morris Disability Questionnaire) were assessed at baseline and 3, 6, 9, and 12 months. Latent class growth analysis (LCGA) was used to model pain and disability scores over time. Baseline biopsychosocial characteristics were compared using one-way analysis of variance or Chi-square test (α=0.05). The LCGA identified three and four trajectories in the pain and disability courses, respectively. Trajectories with low, intermediate, or high scores over time were defined. Worse biopsychosocial status at baseline was associated with worst prognosis over 12 months. Low educational level, physical inactivity, poor mobility, recent falls, worse fall self-efficacy, presence of depressive symptoms, more kinesiophobia, greater number of comorbidities, and the presence of other LBP-associated complaints were found in older adults with severe and persistent symptoms. The trajectories allow the identification of clusters with similar clinical prognoses in older adults with a new episode of LPB. In practice, excessive treatments and unnecessary tests can be avoided, while more accurate and targeted interventions can be implemented.