(Research Hub Theater) Functional Trajectory of Individuals with Low Back Pain Characterized by the AAPM&R Registry

Objective: The study aims to report the collective progress with AAPM&R Low Back Pain Registry, reporting body function changes (‘BF’ pain, anxiety, depression, fatigue, sleep disturbance), activity limitations (AL), and participation restrictions (PR) in individuals with low back pain (ILBP) using the International Classification of Functioning, Disability and Health’s (ICF) disablement components; and, appraising the general health status (GHS) of ILBP.

Design: Observational study from prospective data of AAPM&R Low Back Pain Registry, date range: 09/01/21-01/20/23

Setting: Institutions enrolled in the AAPM&R Registry

Participants: N=320 total (140 males/180 females); age group: >/= 65 years old, 45% study population; 50-64 y.o., 29%; 30-49 y.o, 21%.

Interventions: N/A

Main Outcome Measures: Functional performance (FP) qualifiers were quantified by the respective Patient Reported Outcome Measurement Information System-29-v2.0 (PROMIS) sub-scales: BF changes, by the PROMIS for pain, anxiety, depression, fatigue, and sleep disturbance (SD); AL, by PROMIS-Physical-Function (PF); PR, by PROMIS-ability-to-participate-in-social-roles (Soc); and, GHS, by PROMIS-Pain-Interference (PI).

Results: Diagnoses associated/reported include: Lumbar radiculopathy (28.6%), Lumbar spondylosis 16.6%), Myalgia (7.5%), Lumbar stenosis with neurogenic claudication (6.5%) and without (5.7%), Other intervertebral disc degeneration (5.3%). ILBP’s BF changes included: pain intensity (Numerical Rating Scale: 0-10) 5.94; and PROMIS T-scores (standardized mean 50) as follows: anxiety 50.65; depression 48.56; fatigue 52.02; SD 51.71; PF 39.49; Soc 46.03; and, PI 61.63.

Conclusions: Physiatrists assess ILBP in which anxiety, depression, and fatigue were stratified within population norms but with the following FP changes: moderate pain intensity, severe AL, and moderate PR. Notably, physiatrists provide care for individuals with moderate changes in their GHS. Many ILBP were found to have functional impairments that could have been potentially overlooked during their rehabilitation course. By characterizing LBP impact on these functional measures, this study will continue to describe the ongoing value of physiatry care and associated registry data collection in ILBP.