Predictors of response to physical exercise for low back pain: a secondary analysis of the ReViEEW trial.

BACKGROUND

Non-specific low back pain (nsLBP) is a prevalent and disabling condition, especially among eldercare workers. Although physical exercise is strongly recommended for nsLBP, individual responses vary considerably. Understanding the characteristics that distinguish responders from non-responders could lead to more personalized and effective interventions.

OBJECTIVES

To identify predictors of response to physical exercise for nsLBP in eldercare workers.

DESIGN

Secondary analysis of the ReViEEW randomized controlled trial.

METHODS

Participants (n = 77) with baseline nsLBP intensity of ≥2 on the 0-10 numerical rating scale were included. The intervention consisted of a 12-week, twice-weekly videoconference-supervised exercise program. Responders were defined as those with ≥2-point reduction in pain post-intervention. Thirty-eight variables across eight multidimensional domains were compared between responders and non-responders using independent samples T or Mann-Whitney U tests. Variables showing between-group differences (p < 0.1) were entered into multiple logistic regression analysis.

RESULTS

Thirty-nine participants (51 %) were classified as responders. Of the 38 variables only three differed between groups: responders had significantly higher nsLBP intensity (p = 0.045), lower anxious symptomatology (p = 0.040), and lower hypnotic/anxiolytic medication use (p = 0.092) compared to non-responders. In the regression model, higher baseline pain intensity independently predicted favorable response (OR = 1.37; 95 % CI: 1.03-1.81), while higher anxiety predicted poorer response (OR = 0.79; 95 %CI: 0.64-0.97).

CONCLUSIONS

Higher baseline pain intensity and lower anxiety levels were independent predictors of favorable response to physical exercise for nsLBP in eldercare workers. These findings may inform more targeted clinical decision-making and treatment selection in this population.

TRIAL REGISTRATION: ClinicalTrials.gov, (NCT05050526). Registered 20 September 2021-Prospectively registered.