The smallest worthwhile change on function from a self-management intervention for non-persistent low back pain

Carolina Gassen Fritsch; Paulo H Ferreira; Thomas Lung; Andrew J McLachlan; Manuela L Ferreira

doi:10.1007/s00586-023-07633-4

The smallest worthwhile change on function from a self-management intervention for non-persistent low back pain

Eur Spine J. 2023 Sep;32(9):3272-3279. doi: 10.1007/s00586-023-07633-4. Epub 2023 Jun 14.

Authors

Carolina Gassen Fritsch¹, Paulo H Ferreira², Thomas Lung³, Andrew J McLachlan⁴, Manuela L Ferreira⁵

Affiliations

¹ Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Level 10, Kolling Building, Royal North Shore Hospital, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia. carolina.gassenfritsch@sydney.edu.au.
² Musculoskeletal Health Research Group, Sydney Musculoskeletal Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
³ Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
⁴ Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
⁵ Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Level 10, Kolling Building, Royal North Shore Hospital, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia.

PMID: 37314579
DOI: 10.1007/s00586-023-07633-4

Abstract

Purpose: To determine: (1) the smallest change in function patients would need to see following a self-management intervention for low back pain (LBP) to consider it worthwhile; (2) the association between patient-related factors and the magnitude of the smallest worthwhile change.

Methods: A cross-sectional analysis of 212 participants of the TEXT4myBACK randomised trial was conducted. At baseline, participants nominated the smallest change in function (0-30 scale) following a self-management program they would need to reach to consider it worthwhile. A multivariate regression model estimated the effects of demographic, comorbidities, lifestyle and LBP-related factors on the smallest worthwhile change estimates.

Results: On average, people with LBP need to experience an improvement of at least 9.4 points (SD: 5.7) in function to consider a self-management intervention worthwhile. Only baseline function severity was significantly associated with the smallest worthwhile estimate (-0.60; 95%CI - 0.76, - 0.44).

Conclusion: On average, an improvement of 9.4 points (or 31%) in function is considered by people with LBP as the smallest change that makes self-management worthwhile. Those with lower levels of function needed to experience greater improvements.

Keywords: Function; Low back pain; Self-management; Sufficiently important difference.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Humans
Low Back Pain* / therapy
Self-Management*