Gregory E Hicks1, Ryan T Pohlig2,3, Peter C Coyle1, J Megan Sions1, Debra K Weiner4,5,6,7,8, Jenifer M Pugliese1, Teonette O Velasco9, Victoria A O'Brien10. 1. Department of Physical Therapy, University of Delaware, Newark, Delaware, USA. 2. Department of Epidemiology, University of Delaware, Newark, Delaware, USA. 3. Biostatistics Core, University of Delaware, Newark, Delaware, USA. 4. Clinical and Translational Sciences Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. 5. Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA. 6. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. 7. Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. 8. Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. 9. National Capital Region, The Geneva Foundation, Bethesda, Maryland, USA. 10. ChristianaCare Health System, Newark, Delaware, USA.
Abstract
OBJECTIVE: The purpose of this study is to identify geriatric chronic low back pain (LBP) subgroups based on the presence of potentially modifiable hip impairments, using Latent Variable Mixture Modeling (LVMM), and to examine the prospective relationship between these subgroups and key outcomes over time. METHODS: Baseline, 3-month, 6-month, and 12-month data were collected from a prospective cohort of 250 community-dwelling older adults with chronic LBP. Comprehensive hip (symptoms, strength, range of motion, and flexibility), LBP (intensity and disability), and mobility function (gait speed and 6-Minute Walk Test) examinations were performed at each timepoint. Baseline hip measures were included in LVMM; observed classes/subgroups were compared longitudinally on LBP and mobility function outcomes using mixed models. RESULTS: Regarding LVMM, a model with 3 classes/subgroup fit best. Broadly speaking, subgroups were differentiated best by hip strength and symptom presence: subgroup 1 = strong and nonsymptomatic, subgroup 2 = weak and nonsymptomatic, and subgroup 3 = weak and symptomatic (WS). Regarding longitudinal mixed models, all subgroups improved in most outcomes over time. Specifically, over 12 months, the nonsymptomatic subgroups had lower LBP intensity and disability levels compared with the WS subgroup, whereas the strong and nonsymptomatic subgroup had better mobility function than the 2 "weak" subgroups. CONCLUSION: These subgroup classifications may help in tailoring specific interventions in future trials. Special attention should be given to the WS subgroup given their consistently poor LBP and mobility function outcomes. IMPACT: Among older adults with chronic low back pain, there are 3 hip subgroups: "strong and nonsymptomatic," "weak and nonsymptomatic," and "weak and symptomatic." People in these subgroups demonstrate different outcomes and require different treatment; proper identification will result in tailored interventions designed to benefit individual patients. In particular, people in the WS subgroup deserve special attention, because their outcomes are consistently poorer than those in the other subgroups.
OBJECTIVE: The purpose of this study is to identify geriatric chronic low back pain (LBP) subgroups based on the presence of potentially modifiable hip impairments, using Latent Variable Mixture Modeling (LVMM), and to examine the prospective relationship between these subgroups and key outcomes over time. METHODS: Baseline, 3-month, 6-month, and 12-month data were collected from a prospective cohort of 250 community-dwelling older adults with chronic LBP. Comprehensive hip (symptoms, strength, range of motion, and flexibility), LBP (intensity and disability), and mobility function (gait speed and 6-Minute Walk Test) examinations were performed at each timepoint. Baseline hip measures were included in LVMM; observed classes/subgroups were compared longitudinally on LBP and mobility function outcomes using mixed models. RESULTS: Regarding LVMM, a model with 3 classes/subgroup fit best. Broadly speaking, subgroups were differentiated best by hip strength and symptom presence: subgroup 1 = strong and nonsymptomatic, subgroup 2 = weak and nonsymptomatic, and subgroup 3 = weak and symptomatic (WS). Regarding longitudinal mixed models, all subgroups improved in most outcomes over time. Specifically, over 12 months, the nonsymptomatic subgroups had lower LBP intensity and disability levels compared with the WS subgroup, whereas the strong and nonsymptomatic subgroup had better mobility function than the 2 "weak" subgroups. CONCLUSION: These subgroup classifications may help in tailoring specific interventions in future trials. Special attention should be given to the WS subgroup given their consistently poor LBP and mobility function outcomes. IMPACT: Among older adults with chronic low back pain, there are 3 hip subgroups: "strong and nonsymptomatic," "weak and nonsymptomatic," and "weak and symptomatic." People in these subgroups demonstrate different outcomes and require different treatment; proper identification will result in tailored interventions designed to benefit individual patients. In particular, people in the WS subgroup deserve special attention, because their outcomes are consistently poorer than those in the other subgroups.
Authors: Erika Nelson-Wong; Diane E Gregory; David A Winter; Jack P Callaghan Journal: Clin Biomech (Bristol, Avon) Date: 2008-02-20 Impact factor: 2.063
Authors: Damian Hoy; Lyn March; Peter Brooks; Fiona Blyth; Anthony Woolf; Christopher Bain; Gail Williams; Emma Smith; Theo Vos; Jan Barendregt; Chris Murray; Roy Burstein; Rachelle Buchbinder Journal: Ann Rheum Dis Date: 2014-03-24 Impact factor: 19.103
Authors: Jenifer M Pugliese; Peter C Coyle; Patrick J Knox; J Megan Sions; Charity G Patterson; Ryan T Pohlig; Corey B Simon; Debra K Weiner; Steven Z George; Sara Piva; Gregory E Hicks Journal: Phys Ther Date: 2022-01-01
Authors: Patrick J Knox; Ryan T Pohlig; Jenifer M Pugliese; Peter C Coyle; Jaclyn M Sions; Gregory E Hicks Journal: Arch Phys Med Rehabil Date: 2021-09-20 Impact factor: 3.966
Authors: Patrick J Knox; Corey B Simon; Ryan T Pohlig; Jenifer M Pugliese; Peter C Coyle; Jaclyn M Sions; Gregory E Hicks Journal: Clin J Pain Date: 2021-12-24 Impact factor: 3.442