Biopsychosocial Factors Affecting Disability in Individuals with Chronic Nonspecific Low Back Pain: A Cross-Sectional Study

Abstract

Purpose: Chronic nonspecific low back pain (CNLBP) is a multifactorial condition influenced by clinical, physical, and psychological factors and is associated with pain, impaired balance, reduced muscle performance, kinesiophobia, and altered spinal mechanics. This cross-sectional study aimed to identify the clinical, psychological, and physical performance–related factors associated with disability in individuals with CNLBP. Patients and Methods: A total of 252 individuals diagnosed with CNLBP were included in the study. Each individual was evaluated using the Oswestry Disability Index (ODI), Visual Analog Scale (VAS), Biodex balance device, Five Times Sit and Stand Test (FTSST), Tampa Kinesiophobia Scale (TKS), Timed Up and Go Test (TUG), goniometric measurement, Beck Depression Inventory (BDI), and spinal mouse. Relationships between variables were examined using multiple linear regression was performed to identify independent predictors of disability. Results: Significant correlations were found between ODI and VAS, TKS, BDI, lumbar range of motion values, FTSST, static and dynamic balance values, TUG, and spinal evaluations. In addition, these related parameters explained 81.1% of the variance of ODI score, according to the results of linear regression analysis. In addition, according to the results of linear regression analysis, VAS activity, TKS, FTSST, lumbar extension angle, TUG, spinal posture score, spinal control score, static anteroposterior, and dynamic overall balance score were found to be independent predictors of ODI score. Our study showed that activity pain intensity, kinesiophobia level, lower extremity muscle strength, static anteroposterior and dynamic total balance score, lumbar extension angle, functional status, spinal posture, and spinal control score were predictors of disability level in individuals with CNLBP. Conclusion: Activity pain, kinesiophobia, lower extremity strength, lumbar extension, functional status, spinal posture and control, and balance were independent predictors of disability in individuals with CNLBP. These factors should be considered when developing evaluation and treatment programs for CNLBP.