Back Pain, Low Back Pain, Spondylitis, Ankylosing
Conditions
Keywords
Inflammatory back pain, Ankylosing spondylitis, Non-specific low back pain, Pain experience, Disability, Behavioural, Psychological, Biopsychosocial, Pain profiles
Brief summary
The biopsychosocial model is well established in chronic low back pain (CLBP) research. Nevertheless, researchers to date have overlooked the biopsychosocial aspects of Inflammatory Low Back pain (ILBP). Most health care providers are biologically oriented in their treatment of ILBP, neglecting its possible multidimensional nature. It is true that people with ILBP may present with more complex pain and physical limitations than those with chronic non-specific low back pain (CNSLBP), but it remains unexplored whether or not these limitations are affected by the same pain factors that affect CNSLBP patients. This study aims to explore and compare the biopsychosocial back pain profiles of adults with ILBP and CNSLBP.
Detailed description
This is a multicentre case-control study that will compare back pain in patients with ankylosing spondylitis and CNSLBP. A multidimensional pain assessment will be conducted for patients in both groups. Each patient will be assessed on one occasion by the same experienced physiotherapist.
Interventions
None listed
Sponsors
University of Dublin, Trinity College
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Adult between 18 and 65 years of age * Low back pain \>3 months * On stable medication * Ability to walk independently without an assistive device * Specific inclusion criteria for AS group: clinical diagnosis of ankylosing spondylitis by a rheumatologist * Specific inclusion for CNSLBP group: clinical diagnosis by a physician for CLBP
Exclusion criteria
* Spinal surgery or compression fracture within the last 6 months * Cauda equine and conus medullaris syndromes * Severe musculoskeletal conditions affecting the upper and/or the lower limbs, such as severe inflammatory arthritis of the peripheral joints * Severe osteoporosis * Leg-length discrepancy * Cancer * Morbid obesity, or pregnancy * Progressive neurological disease * Psychiatric disease and/or cognitive limitations that could affect the ability to complete the study questionnaires * Inability to read and/or understand the English language * Severe cardiac, respiratory or neurological diseases * Uncontrolled epilepsy * Specific
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Back pain intensity - total | Day 1, no follow-up will be required. | The average total back pain intensity in the last week will be measured by the Numeric Rating Scale (NRS) |
| Back pain-related functional disability | Day 1, no follow-up will be required. | Oswestry Disability Index (ODI) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Back pain beliefs | Day 1, no follow-up will be required. | Back Beliefs Questionnaire (BBQ) |
| Pain-related fear, fear of movement/(re)injury | Day 1, no follow-up will be required. | Tampa Scale for Kinesiophobia (TSK) |
| The fear-avoidance behaviours of physical activity | Day 1, no follow-up will be required. | modified Fear Avoidance Behaviour Questionnaire (mFABQ) |
| Pain catastrophizing behavior | Day 1, no follow-up will be required. | Pain catastrophizing scale (PCS) |
| Self-efficacy for AS patients | Day 1, no follow-up will be required. | Ankylosing Spondylitis-specific Arthritis Self-Efficacy Scale (ASES-AS) |
| Pain cognition and coping | Day 1, no follow-up will be required. | Pain Coping Inventory (PCI) |
| Psychological distress (depression & anxiety) | Day 1, no follow-up will be required. | Hospital Anxiety and Depression Scale (HADS) |
| The extent and location of pain | Day 1, no follow-up will be required. | Pain drawings will be completed for NSCLBP patients on a digital tablet (iPad 2, Apple Computer, Cupertino, CA, USA) using a commercially available sketching software (SketchBook) |
| Back pain intensity - nocturnal | Day 1, no follow-up will be required. | The average nocturnal back pain intensity in the last week will be measured by the Numeric Rating Scale (NRS) |
| Physical function for AS patients | Day 1, no follow-up will be required. | Bath Ankylosing Spondylitis Functional Index (BASFI) |
| Disease activity for AS patients | Day 1, no follow-up will be required. | Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) |
| Global well-being for AS patients | Day 1, no follow-up will be required. | Bath Ankylosing Spondylitis Global score (BAS-G) |
| Flexibility and spinal mobility for AS patients | Day 1, no follow-up will be required. | Bath Ankylosing Spondylitis Metrology Index (BASMI) |
| Chest expansion | Day 1, no follow-up will be required. | Chest expansion will be measured circumferentially using a tape measure |
| Forward bending | Day 1, no follow-up will be required. | Finger-to-Floor Distance in centimetres (cm) will be measured using a tape measure |
| Isometric endurance of the trunk extensor muscles | Day 1, no follow-up will be required. | Ito test |
| Isometric endurance of the the trunk flexor muscles | Day 1, no follow-up will be required. | Shirado test |
| Grip strength | Day 1, no follow-up will be required. | Hand grip dynamometer (Jamar Hydraulic Hand Dynamometer) |
| Functional performance | Day 1, no follow-up will be required. | 50-foot walk test |
| Functional performance and endurance | Day 1, no follow-up will be required. | 6-min walk distance (6MWD) test |
Countries
Ireland
Outcome results
None listed