Relating the Diers formetric measurements with the subjective severity of acute and chronic low back pain

Abstract

Background context: Nonspecific low back pain (LBP) is a common disorder with a high economic, social and psychological burden. Many systems have been developed for evaluating the severity of LBP, though these are mainly based on scoring questionnaires for the functional status of the patients. Objective quantifiable methods relating LBP with anthropometric factors are scarce.

Purpose: To find the correlates of nonspecific LBP with spine shape variables and demographic characteristics. To investigate the possible relationship between the latter and the result of a questionnaire subjectively quantifying the severity of LBP.

Study design/setting: This is a pragmatic observational prospective cohort study.

Patient sample: 218 subjects participated in this study. A first group of participants were 160 patients consulting at an osteopathic outpatient clinic for back pain complaints. The second group consisted of 58 healthy pain-free volunteers.

Outcome measures: The Oswestry Disability Index (ODI) was used to quantify the degree of functional impairment due to low back pain. The surface topography of the back was registered statically with the Diers-4D formetric® system.

Methods: Multivariate analyses of the DIERS 4D formetric system recordings in the subjects with or without nonspecific, acute or chronic LBP.

Results: Different patterns between female and male subjects were found. Age, coronal and sagittal imbalance correlated with LBP in female subjects, whereas pelvic inclination, the trunk torsion and apical deviation correlated with LBP in male. Multivariate analyses allowed creating an algorithm to predict the functional disability (predicted LBP-score, PLBP), based on the above variables for females and males. Logistic stepwise regression analysis indicated the probability of a patient having a LBP-score above or below ODI 20 (P= <0.0001), which is considered the clinically relevant threshold value for justifying absence from work.

Conclusions: In this study LBP was correlated with spine shape variables leading to an algorithm predicting the functional disability of a patient due to LBP. Discrepancies between the model and the ODI result may suggest elements that are clinically relevant.