Physiotherapy and low back pain - part ii: outcomes research utilising the biopsychosocial model: biological outcomes

Abstract

Low back pain (LBP) is an acknowledged major health problem that is associated with high recurrence rates and increased chronic incapacity. It is one of the most common and costly conditions treated  by physiotherapists and therefore the physiotherapy profession has a responsibility to provide evidence of effectiveness of interventions for LBP.The quality and rigour of published research on LBP has been found lacking and has predominately utilised a biomedical model of health that focuses on disease and system pathology rather than on illness. Outcomes research has the potential to advance the quest for evidence of effective management of LBP. Patients with CLBP and disability face complex biopsychosocial problems, hence a multifactorial model of illness is particularly pertinent and is addressed by the outcomes research model. Outcome measures that are valid, reliable and responsive are necessary to determine effective interventions for LBP. Biological, psychological and social variables shape the experience and outcome of an episode of LBP and outcome measures reflecting all three aspects of the biopsychosocial model are important to the study of LBP. Outcome measures reflecting the biological component of the biopsychosocial model are discussed in part II: measures of pain and aspects of movement dysfunction.