Impact of chronic low back pain on activities of daily living among patients with low back pain attended at the musculoskeletal department, CRP, SAVAR, DHAKA, BANGLADESH.

Abstract

Background: Low back pain (LBP) is extremely prevalent musculoskeletal condition affecting about 60-80% of world population at some points in their lives. It is considered as a leading cause of activity limitation causing difficulty and interference in executing the tasks including basic activities of daily living to work related activities. Objective: The major aim of the present study was to assess the effect of chronic LBP on activities of daily living and to describe the associations between outcome measures with different variables. Methods: A descriptive cross-sectional study was carried out, 190 patients with chronic LBP (pain duration >3 months) of age range 18-65 years were recruited. Data was collected through convenience sampling. Tools used were Visual Analog Scale, Low back Specific Version of SF-36 Physical Functioning Questionnaire and Fear Avoidance Belief on Physical activities Questionnaire. Data was analyzed in SPSS-25 version, and tests employed were Chi square (χ2), Spearman rank correlation, Independent t-test and Multiple regression. Results: Mean age was 39.04±11.4 years with high prevalence among females, and majority had difficulty in ADL since 0-5 months. Severe limitation in ADL found were lifting heavy objects, vigorous activities, prolong sitting, bending/kneeling, standing, walking 1km distance, climbing several flights of stairs, getting in and out of the bus/rickshaw, and turning over in bed respectively. A negative, intermediate, significant correlation was found between pain intensity and FAB-PA with ADL (pvalue = 0.000) and weak-positive, significant correlation between pain intensity and FAB-PA (p-value = 0.05). Statistical significant difference in mean ADL score was found between male and female but the effect size of these difference was small. A step-wise multiple regression analysis evaluated that pain intensity, FAB-PA and age had significant effect (p-value = 0.000) on patient ADL function. Conclusion: Functional capacity among CLBP patients is limited either severely or moderately by pain. Pain intensity and FAB-PA found to have the potential to decrease capacity to perform ADL in patients with CLBP. Key words: Low back pain, CLBP, ADL, Activity limitation, Fear Avoidance Belief on Physical Activity.