Classification of low-back-related leg pain consulters using latent class analysis

Stynes, S. M.; Konstantinou, K.; Ogollah, R.; Dunn, K.

Abstract

Background
Low back-related leg pain (LBLP) is clinically diagnosed as referred leg pain or sciatica. Within the spectrum of LBLP there may be unrecognised subgroups of patients. This study aimed to identify and describe clusters of LBLP patients using latent class analysis (LCA).

Methods
The study population were 609 LBLP primary care consulters. Variables from clinical assessment were included in the LCA. Characteristics of the statistically identified clusters were described and compared to the clinically defined groups of LBLP patients.

Results
A five cluster solution was optimal. Cluster one (n=104) had mild leg pain severity, no clinical signs suggestive of sciatica and more anxiety. Cluster two (n=122), three (n=188) and four (n=69) represented mild, moderate and severe sciatica in terms of response to clinical assessment items, pain severity and impact on function. Cluster five (n=126) was more difficult to define based on response to clinical assessment items (below knee pain and possible neural tension) and had a similar severe profile to cluster four in terms of high pain, disability, psychosocial factors, work impact and risk of poor outcome; but had longer duration pain and more comorbidities.

Cluster three consistently mirrored the profile of the overall group of patients with a clinical diagnosis of sciatica. Cluster one mirrored the referred leg pain group.

Conclusion
This is the first study that used LCA to classify LBLP patients, including sciatica. These clusters could represent more homogenous groups that may require different treatment approaches. Further work will describe the clinical course and longer term

Citation

Stynes, S. . M., Konstantinou, K., Ogollah, R., & Dunn, K. (2018). Classification of low-back-related leg pain consulters using latent class analysis. Orthopaedic Proceedings, 99-B(SUPP_10), 17. https://doi.org/10.1302/1358-992X.99BSUPP_10.SBPR2016-017

• Journal Article Type: Conference Paper
• Conference Name: The Society for Back Pain Research (SBPR) - Annual General Meeting 2016
• Online Publication Date: May 1, 2017
• Publication Date: Feb 21, 2018
• Deposit Date: Jun 21, 2023
• Journal: Orthopaedic Proceedings
• Print ISSN: 2049-4416
• Publisher: Bone & Joint
• Peer Reviewed: Peer Reviewed
• Volume: 99-B
• Issue: SUPP_10
• Pages: 17
• DOI: https://doi.org/10.1302/1358-992X.99BSUPP_10.SBPR2016-017
• Publisher URL: https://boneandjoint.org.uk/Article/10.1302/1358-992X.99BSUPP_10.SBPR2016-017