Disclosures: Gerold R. Ebenbichler, MD:

Objective: Whereas rehabilitation effectively improves back-related health in persons with chronic low back pain (cLBP), it remains widely unknown if the International Classification of Functioning and Health (ICF) context factors “age” and “sex” would impact the disablement and respective improvement with rehabilitation as classified with the ICF core set for cLBP in these persons. Furthermore, associations between limitations/restrictions and measures of body function or quality of life were of interest.

Design: Prospective observation with assessments before and after six months of outpatient rehabilitation.Setting : Outpatient rehabilitation center.Participants : 1512 employed cLBP patients for whom complete data sets were available.

Interventions: Comprehensive rehabilitation comprising 42 progressive resistance training sessions (90 minutes each), 13 psychological counselling and relaxation technique sessions (60 minutes each), and five educational sessions (two on information about spinal function and pathologies, two on ergonomics and healthy alimentation, and one educational psychology session, 60 minutes each).

Main Outcome Measures: ICF-activity/participation core categories automatically predicted from random forests (machine learning area) and utilizing information from the Roland Morris Disability (RMDQ) and Pain Disability Index (PDI). Further measures were the European quality of life (EQ5D) questionnaire; maximum isometric trunk muscle strength, lumbar range of motion, and pain intensity ratings studied associations.

Results: Generalized linear-mixed models that explored the ICF categories for age- and gender-specific differences revealed that upon completion of rehabilitation the presence of a limitation within the ICF activity “walking” significantly decreased with significant between-group differences. The category “doing housework” revealed gender-specific differences, and both gender- and age-specific differences were observed for work-related participation categories. There were no meaningful associations between ICF limitation/restriction categories and Qol or body function measurement scores (point-biserial/Spearman correlation tests).Conclusions: “Age” and “gender” drive differences in some categories within the ICF activity/restriction categories of persons with cLBP; if these two features are not addressed through appropriate interventions, rehabilitation outcome may remain suboptimal in these patients.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/do-age-and-gender-impact-limited-activity-and-restricted-participation-icf-category-profiles-in-multimodal-chronic-back-pain-rehabilitation/