Investigation of factors affecting disability in individuals with chronic nonspecific low back pain

Chronic nonspecific low back pain (CNLBP) is an important health problem that causes serious physical, psychological and economic losses in developed and developing countries. It significantly limits the daily life activities of individuals, including work life. In this case, it negatively affects the quality of life, physical and psychological conditions of individuals. A large part of the negative effects seen in the health system and quality of life can be attributed to disability caused by pain. The relationship between chronic low back pain and disability is a complex and multifactorial phenomenon. Many studies have focussed on determining the prevalence of pain and factors that may affect pain, but have not considered disability that may be associated with this condition. In this context, the aim of this study is to examine the factors affecting disability in individuals with CNLBP. This study was planned as an observational study. The study population consisted of patients diagnosed with CNLBP by a specialised doctor of physical medicine and referred to Kırşehir Ahi Evran University School of Physical Therapy and Rehabilitation for treatment between September 2024 and March 2025. The disability level of the patients was assessed by Oswestry Disability Index (ODI), pain severity by visual analogue scale (VAS), kinesiophobia level by Tampa Kinesiophobia Scale (TKS), depression severity by Beck Depression Scale (BDS), balance assessment by Biodex balance device, Range of motion (ROM) was assessed with a manual goniometer, lower extremity muscle strength was assessed with the five times sit to stand test (FTSST), functional status was assessed with the Timed Up and Go test (TUG) and spinal status was assessed with a spinal mouse. The relationship between independent variables was evaluated by Pearson correlation analysis. Multiple linear regression analysis was used to determine the determinants of disability level. The study included 252 individuals, 134 women and 118 men, with a mean age of 46.49±12.61 years. Statistically significant correlations were found between ODI and VAS, TKS, BDS, dynamic and static balance parameters, lumbar region ROM angle values, FTSST, TUG and spinal evaluations (p<0.05). In addition, according to the results of linear regression analysis, VAS, TKS, BDS, dynamic and static balance parameters, lumbar region ROM angle values, FTSST, TUG and spinal evaluations explained 81.1% of the variance as independent determinants of the ODI score in individuals with CNLBP. The results of the study showed that activity pain intensity, kinesiophobia level, lower extremity muscle strength, static anteroposterior and dynamic total balance score, extension lumbar range of motion, functional status, spinal posture and spinal control score were predictors of disability level in individuals with CNBP. Since these factors, which are associated with the level of disability in individuals with CNLBP, are also determinants of the level of disability, we think that they should not be ignored during evaluation and planning of treatment programmes.