CLINICAL CHARACTERIZATION OF HIP SUBGROUPS IN GERIATRIC CHRONIC LOW BACK PAIN.

Abstract

Objective: To investigate and compare the clinical profiles of three previously established hip-based subgroups of older adults with chronic low back pain (LBP) using data from multiple domains.

Design: Cross-sectional analysis of baseline cohort study data.

Setting: Clinical Research Laboratory.

Participants: 250 Community dwelling older adults with chronic LBP.

Interventions: Not applicable.

Main outcome measures: Clinical profiles of the previously derived subgroups were established. Pain quality and dispersion were captured with the McGill Pain Questionnaire. Self-efficacy was measured using the Low Back Activity Confidence Scale. Catastrophic thoughts about LBP were captured with the Pain Catastrophizing Scale. Trunk mobility was measured with an inclinometer. Trunk muscle function was captured through standardized muscle endurance testing and ultrasound measures of muscle activity. One-way analysis of variance was used to analyze between-group differences.

Results: Each chronic LBP subgroup was named based on the level of hip strength and hip symptoms: weak/symptomatic (WS), weak/non-symptomatic (WNS) and strong/non-symptomatic (SNS). The WS subgroup had distinctly worse levels of pain quality, dispersion, catastrophizing and self-efficacy, compared to the other two subgroups. In contrast, the SNS subgroup, as compared to the other subgroups, had greater thoracolumbar flexion, greater trunk muscle endurance and better psychological profiles.

Conclusion: The unique clinical profile of each subgroup underscores how important it is to consider the heterogeneous nature of chronic LBP in the geriatric population when developing treatment approaches. The clinical characterization of these subgroups across multiple rehabilitation-focused domains may optimize the development of tailored interventions for each subgroup.