The major goal of a past funded grant project was to identify predictors of when acute low back pain incidents are likely to develop into chronic disability problems. With the great economic costs and traditionally poor outcomes among chronic low back pain patients, it has become increasingly more important to effectively treat patients in the acute stage in order to prevent these more chronic disability problems. Results of the past project clearly isolated some significant psychosocial risk factors predict the development of chronicity. As an extension of these important findings, a statistical algorithm was developed that can be used to identify acute low back pain patients who are prime candidates for early intervention in order to prevent chronicity. The present project will involve the assessment of a large cohort of acute low back patients (n=700) in order to screen out those patients who are at high risk for developing chronicity. These high risk patients will then be randomly assigned to one of two groups (30 patients/group): a functional restoration intervention group or a nonintervention group. Initial exploratory analyses of individual differences in response to intervention, as well as relationships between personality disorders and coping styles, will also be conducted. One-year follow-up evaluations will be collected in order to assess important socioeconomic outcomes such as return-to-work and health-care-utilization rates. It is hypothesized that early intervention at the acute stage will prevent the development of chronic disability. In addition, as a replication of the previous grant project results, the nonintervention group will be compared to a demographically matched cohort (n=60) of initially assessed acute patients who do not display the at-risk profile. It is hypothesized that the """"""""at-risk"""""""" nonintervention patients will display significantly higher rates of chronic disability at one year relative to the """"""""not-at-risk"""""""" profile patients. These results will have major implications for effective intervention and resultant significant health-care-cost savings for this prevalent disability problem.
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