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13-year Follow-up of Women With Chronic Low Back Pain in Primary Care - a Prospective Longitudinal Cohort Study

25 maggio 2026 aggiornato da: Vastra Gotaland Region

Background: Low back pain (LBP) is among the main causes of long-term sickness absence and is associated with considerable costs for both the individual and society. LBP affects 60-80% of the population and most individuals recover, while about 10-20% develop persistent pain and disability. Women have a higher risk of developing chronic LBP (CLBP) and widespread pain.

Purpose: To investigate change in body function, activity, participation and other health related factors in women with CLBP after 13 years and to identify prognostic factors for pain, activity limitation and work ability.

Methods: In the present study, all women (n = 131) who were included in the cross-sectional study in 2006 and who were followed-up after 2 years are now invited to the same study-protocol 13 years after the first examination in 2006.

The Swedish Ethical Review Authority approved the study. Dnr: 2019-01944, 2019-05-21.

Panoramica dello studio

Descrizione dettagliata

Background: Low back pain (LBP) is among the main causes of long-term sickness absence and is associated with considerable costs for both the individual and society. LBP affects 60-80% of the population and most individuals recover, while about 10-20% develop persistent pain and disability. Women have a higher risk of developing chronic LBP (CLBP) and widespread pain.

How LBP develops into recurrent and or more persistent pain with disability is not fully understood. Prognostic factors for pain development, work ability and self-rated activity limitation in 1 and 2-year follow-ups of persons with CLBP who sought primary care are described. Performance on physical capacity tests (6-min walking test), limitations on self-rated activity and participation and psycho-social factors play a role in unfavorable pain and function development. However, there are patients with CLBP who have no anatomical, demographic or psychosocial explanation of their symptoms. Some people with CLBP also have widespread pain and show altered pain sensitivity as fibromyalgia.

Purpose:To investigate change in body function, activity, participation and other health related factors in women with CLBP after 13 years and to identify prognostic factors for pain, activity limitation and work ability.

Methods: In the present study, all women (n = 131) who were included in the cross-sectional study in 2006 and who were followed-up after 2 years are now invited to the same study-protocol 13 years after the first examination in 2006.

Participants will be assessed by a registered physiotherapist at one occasion. Demographic data are collected, Questions about social support, sleep quality and sleep quantity, smoking and alcohol consumption. Self-reported questionnaires, pain and function performance tests will be assessed.

Data Analysis: Descriptive analysis based on data level; mean value (standard deviation), median (25th; 75th percentile), number and proportion will be used to present the group's characteristics. For analysis of change between the first assessment and after 13 years, Wilcoxon's signed rank test will be used for continuous variables and Teckentest / McNemar's test will be used for nominal data.

Multivariable regression analysis will be performed to calculate predictors of pain intensity (VAS), number of pain locations/pain distribution, self-rated activity limitation (RMDQ) and work ability after 13 years. Independent variables will be variables at the first assessment within the domains; body function (pain intensity, pain distribution, pain sensitivity, anxiety, depression, function test and stress), activity (RMDQ) and participation (work ability), as well as other health-related factors (Health-Related Quality of Life (SF-36), Leisure Time Physical Activity Instrument, Experience of Physical Activity). Multivariable regression models will be adjusted for age, level of education and social status. P-value is set to 0.05.

Ethical approval: The Swedish Ethical Review Authority approved the study. Dnr: 2019-01944, 2019-05-21.

Expected Results: The results is expected to provide knowledge about long-term clinical course (13 years) and prognostic factors for a positive pain and function development of CLBP in women seeking primary care.

Tipo di studio

Osservativo

Iscrizione (Effettivo)

87

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

    • Sweden
      • Alingsås, Sweden, Svezia
        • Närhälsan, Region Västra Götaland
      • Borås, Sweden, Svezia
        • R&D primary care, Region Västra Götaland
      • Uddevalla, Sweden, Svezia
        • Närhälsan, Region Västra Götaland

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 18 anni a 75 anni (Adulto, Adulto più anziano)

Accetta volontari sani

No

Metodo di campionamento

Campione non probabilistico

Popolazione di studio

The 183 women who fulfilled the inclusion criteria were invited to participate in the cross-sectional study in 2006 and 131 accepted participation. All 131 from the cross-sectional study are now invited to participate in the present 13-year follow-up.The inclusion criteria at the first assessment in 2006 were: female patient, age between 18 and 60 years, low back pain (pain between costal margins and gluteal folds) with or without referred leg pain. Further criteria were; greater than 12-week's duration of symptoms, not pregnant, no known spinal disorders, no other severe somatic or psychiatric disorders, understanding in Swedish.

Descrizione

Inclusion Criteria:

  • All participants (n=131) included in the Cross Sectional Study in 2006

Exclusion Criteria:

  • Pregnant
  • Serious somatic disorders
  • Serious psychiatric disorders

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Modelli osservazionali: Coorte
  • Prospettive temporali: Prospettiva

Coorti e interventi

Gruppo / Coorte
Intervento / Trattamento
131 participants with chronic low back pain
All the participants (n=131) with chronic low back pain (CLBP) from the cross-sectional study in 2006 are invited to participate in the present 13-year follow-up. The same examination battery used in the cross-sectional study plus a supplementary Chair Stand Test will be used.
13-year prospective longitudinal cohort study

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Activity limitation
Lasso di tempo: 2019, change from the first assessment (2006) to the present 13-year follow-up (2019), identify predictors (2006) for activity limitation (RMDQ) at the 13-year follow-up
Roland and Morris Disability Questionnaire (RMDQ) will be used.
2019, change from the first assessment (2006) to the present 13-year follow-up (2019), identify predictors (2006) for activity limitation (RMDQ) at the 13-year follow-up
Pain intensity
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019), identify predictors (2006) for pain intensity (VAS) at the 13-year follow-up.
A Visual Analogue Scale (VAS), ranging 0 to 100 mm will be used for pain intensity during the last week. 0 mm indicates no pain and 100 mm indicates very severe pain. Higher score indicates more severe pain.
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019), identify predictors (2006) for pain intensity (VAS) at the 13-year follow-up.
Work ability
Lasso di tempo: 2019, Comparison from the first assessment (2006) to the present 13-year follow-up (2019), identify predictors (2006) for work ability at the 13-year follow-up.
Sick-leave periods, and sickness and activity compensation is obtained from the Swedish Social Insurance Agency's MiDAS database. Self-reported work status dichotomized into two categories, work ability or not will be used.
2019, Comparison from the first assessment (2006) to the present 13-year follow-up (2019), identify predictors (2006) for work ability at the 13-year follow-up.

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Pain distribution
Lasso di tempo: 2019, Comparison from the first assessment (2006) to the present 13-year follow-up (2019), identify predictors (2006) for pain distribution at the 13-year follow-up.
A drawing of the body will be used for assessing distribution of pain
2019, Comparison from the first assessment (2006) to the present 13-year follow-up (2019), identify predictors (2006) for pain distribution at the 13-year follow-up.

Altre misure di risultato

Misura del risultato
Misura Descrizione
Lasso di tempo
Walking capacity
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
The 6-minute walk test (6MWT) will be used. The person walks back and forth in a measured distance of 30 meters for 6 minutes. The number of meters achieved is recorded.
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Lower limb muscle endurance and muscle strength
Lasso di tempo: 2019
The Chair Stand Test (CST) will be used.
2019
Hand grip strength
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
The Grippit®, electronic hand strength measurement will be used. Sustained hand grip strength will be measured during 10 seconds for each hand.
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Hand grip strength
Lasso di tempo: 2019
The Jamar Hand Dynamometer®, will be used for measuring hand grip strength for each hand.
2019
Pain sensitivity/pain threshold
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Somedic algometer® will be used.
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Fatigue
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Multidimensional Fatigue Inventory (MFI-20) will be used.
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
General fatigue
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
A Visual Analogue Scale (VAS), ranging 0 to 100 mm will be used for general fatigue during the last week. 0 mm indicates no tiredness and 100 mm indicates very tired. Higher score indicates more severe general fatigue.
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Sleep quantity
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
One question will be used: "Do you think you get enough sleep?" (Range 1-4). Higher score indicate better sleep quantity.
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Sleep quality
Lasso di tempo: Time frame: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019)
One questions will be used: "On the whole, how do you think you sleep?" (Range 1-4). Higher score indicate better sleep quality.
Time frame: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019)
Social support
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
The 4-item version of Medical Outcome Study Social Support Survey will be used.
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Stress
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Stress and Crisis Inventory (SCI-93) will be used for measuring clinical symptoms of stress.
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Physical function
Lasso di tempo: 2019, Comparison from the first assessment (2006) to the present 13-year follow-up (2019).
The Patient Specific Functional Scale (PSFS), will be used for the participant´s self-identified activities that are difficult to perform due to low back pain. Then the participant rates the level of difficulty for each identified activity on an 11-point numeric scale ranging from 0 ("unable to perform activity") to 10 ("able to perform activity unhindered or at pre-injury level").
2019, Comparison from the first assessment (2006) to the present 13-year follow-up (2019).
Leisure Time Physical Activity
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Leisure Time Physical Activity Instrument (LTPAI) will be used to assess the amount of self-rated physical activity in free time during a typical week
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Experience of physical activity
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Experience of physical activity questionnaire will be used.
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Risk for long-term disability and sick-leave
Lasso di tempo: 2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ), estimate the risk for long-term disability and sick-leave. The sum score of 21 items will be used.
2019, Change from the first assessment (2006) to the present 13-year follow-up (2019).
Health-related quality of life
Lasso di tempo: Change from the first assessment (2006) to the present 13-year follow-up (2019).
Short Form-36 (SF-36) will be used to measure health-related quality of life.
Change from the first assessment (2006) to the present 13-year follow-up (2019).
Alcohol consumption
Lasso di tempo: Comparison from the first assessment (2006) to the present 13-year follow-up (2019).
The Alcohol Use Disorders Identification Test (Audit-C) will be used.
Comparison from the first assessment (2006) to the present 13-year follow-up (2019).

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Collaboratori

Investigatori

  • Investigatore principale: Lena Nordeman, PhD, R&D primary care Region Västra Götaland, University of Gothenburg Sweden

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

10 giugno 2019

Completamento primario (Effettivo)

31 marzo 2020

Completamento dello studio (Effettivo)

31 marzo 2020

Date di iscrizione allo studio

Primo inviato

27 maggio 2019

Primo inviato che soddisfa i criteri di controllo qualità

31 maggio 2019

Primo Inserito (Effettivo)

4 giugno 2019

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

28 maggio 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

25 maggio 2026

Ultimo verificato

1 marzo 2025

Maggiori informazioni

Termini relativi a questo studio

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

prodotto fabbricato ed esportato dagli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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