Subgrouping patients with chronic low back pain: What are the differences in actual daily life behavior between patients classified as avoider or persister?

Article type: Research Article

Authors: Huijnen, Ivan P.J.^{a; b; 1; *} | Schasfoort, Fabienne C.^{c; d; 1} | Smeets, Rob J.E.M.^{a; e} | Sneekes, Emiel^{c; d} | Verbunt, Jeanine A.^{a; b} | Bussmann, Johannes B.J.^c

Affiliations: [a] Department of Rehabilitation Medicine, Research Program Functioning and Rehabilitation, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands | [b] Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands | [c] Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands | [d] Rijndam Rehabilitation, Rotterdam, The Netherlands | [e] CIR Revalidatie Location Eindhoven, Eindhoven, The Netherlands

Correspondence: [*] Corresponding author: Ivan P.J. Huijnen, Department of Rehabilitation Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Tel.: +31 43 3882162; E-mail: ivan.huijnen@maastrichtuniversity.nl.

Note: [1] Both authors equally contributed to the organization and execution of the study presented in this manuscript.

Abstract: BACKGROUND AND OBJECTIVE: The purpose of this study is to determine whether patients, classified by their treating consultant in rehabilitation medicine as avoider or persister, show differences in a large set of detailed outcomes of actual, objectively measured daily physical behaviour. METHODS: In this explorative cross-sectional study, 16 patients were included; 9 patients were categorized as avoider and 7 patients as persister. Subjects wore the VitaMove activity monitor, a high-end accelerometry-based device that allowed automatic detection of a large set of body postures and motions. Physical behaviour was assessed in detail by total duration of body postures and motions as percentages of 24 hours, as well as by the number of sit-to-stand transfers, overall activity level, walking speed, and the distribution of bouts of physical activity and sedentary behaviour. Differences between groups were tested with the Mann Whitney U test. RESULTS: There were no significant differences between groups in any of the physical behaviour outcomes. CONCLUSIONS: Our study showed that activity-related behavioural style categorization by consultants in rehabilitation medicine is not expressed in objectively measured detailed outcomes of daily physical behaviour.

Keywords: Activity monitoring, activity-related behaviour, chronic low back pain, excessive persistence, avoidance

DOI: 10.3233/BMR-171048

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 2, pp. 303-311, 2020