The Utility of the ICF brief core set for low back pain for rehabilitation outcome prognosis : poster presentation

Abstract

Introduction. Biopsychosocial disorders caused by persistent pain in lumbosacral radiculopathy are indication to refer patients to multidisciplinary outpatient rehabilitation (OutR). WHO initiative to introduce ICF in the various fields of medicine, primarily in research projects encouraged the search of factors influencing rehabilitation effectiveness using the ICF model. Purpose. The aim of the study was to define the patients state according ICF and determine the factors influencing effectiveness of rehabilitation in lumbosacral radiculopathy. Methods. 111 patients (average age 52.2±11.8 y.) self rated ICF Brief Core set for LBP components in scale from 0 to 4 points at the beginning of OutR. The problems in body functions, activities and participation restrictions were set. Effectiveness of rehabilitation was evaluated by changes in Roland Morris Disability Index and LBP intensity. By these changes patients were divided into groups of lower and higher efficiency of rehabilitation. Results. Only the factors significantly different between the groups of OutR effectiveness were included into logistic regression analysis. An increase by 1 point in the score emotional functions, physical endurance, sleep functions et al. decreased the odds ratio of effective rehabilitation. The multivariate model indicated that the predictive factors of lower effectiveness rehabilitation were body functioning problems - sensation of pain, OR 0.47; 95% CI [0.23-0.94] and sleep disorders, OR 0.64; 95% CI [0.42-0.98]. Discussion. Correlations between sleep disturbance and LBP intensity were found and the management of sleep problems as a goal of rehabilitation in LBP was emphasised by a few authors. Our findings indicated that problems of pain sensation, together with sleep disorders, negatively influenced outcomes of rehabilitation. Predictive value of the results should be verified by further studies. Conclusions. Self rated ICF categories are useful to set the main problems of patients, but application of the ICF Core sets for outcome prognosis remains uncertain.