Abstract
Background
The multidimensional array of clinical features and prognostic factors makes it difficult to optimize management within the heterogeneity of patients with common musculoskeletal pain. This study aimed to identify phenotypes across prognostic factors and musculoskeletal complaints. Concurrent and external validity were assessed against an established instrument and a new sample, respectively, and treatment outcome was described.
Methods
We conducted a longitudinal observational study of 435 patients (aged 18‐67 years) seeking treatment for non‐specific complaints in the neck, shoulder, low back or multisite/complex pain in primary health care physiotherapy in Norway. Latent class analysis was used to identify phenotypes based on eleven common prognostic factors within four biopsychosocial domains; pain, beliefs and thoughts, psychological, and activity and lifestyle.
Results
Five distinct phenotypes were identified. Phenotype 1 (n=77, 17.7%) and 2 (n=142, 32.6%) were characterized by the lowest scores across all biopsychosocial domains. Phenotype 2 showed somewhat higher levels of symptoms across the biopsychosocial domains. Phenotype 3 (n=89, 20.5%) and 4 (n=78, 17.9 %) were more affected across all domains, but phenotype 3 and 4 had opposite patterns in the psychological and pain domains. Phenotype 5 (n=49, 11.3 %) were characterized by worse symptoms across all domains, indicating a complex phenotype. The identified phenotypes had good external and concurrent validity, also differentiating for the phenotypes in function and health‐related quality of life outcome at 3 months follow‐up.
Conclusion
The phenotypes may inform the development of targeted interventions aimed at improving the treatment efficiency in patients with common musculoskeletal disorders.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/31J4PU3
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