Pre-rehabilitation scores of functioning measured using the World Health Organization Disability Assessment Schedule in persons with nonspecific low back pain: a scoping review.
Jessica J Wong, Astrid DeSouza, Sheilah Hogg-Johnson and 12 others
PMID 36112110WHAT IT FOUND
People with chronic low back pain seeking rehab score moderately impaired on the WHODAS, worse than those with acute pain.
The data is sparse, mostly from high-income countries, so these scores are a rough guide rather than a standard benchmark.
Key findings
01Only eight studies provided pre-rehabilitation WHODAS scores for nonspecific low back pain, limiting the certainty of these baseline values.
02In chronic low back pain, mean WHODAS-36 summary scores ranged from 22.8 to 41.5 out of 100, indicating moderate disability.
03Most included studies (7 of 8) were conducted in high-income countries, so these baseline scores may not reflect populations in low- and middle-income settings.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only eight studies were included, which is a very small evidence base for establishing global baseline scores. Seven of the eight studies were conducted in high-income countries, limiting generalizability to low- and middle-income settings. Most studies recruited from clinical or rehabilitation settings, so the scores may not represent people with low back pain in the general population who do not seek care. The review did not search gray literature, which might have missed unpublished data. The heterogeneity in scoring methods (simple vs. complex) and versions (WHODAS-36 vs. 12) makes direct comparison across studies difficult.
Declared interests
One author reports research grants from the Canadian Chiropractic Research Foundation and CIHR. Another reports grants from the Canadian Chiropractic Research Foundation, CIHR, College of Chiropractors of British Columbia, and WHO, as well as payment for expert testimony from chiropractic protective associations. One author holds an unpaid leadership role with World Spine Care and SPINE20.
The easy way to misread this
Do not treat these scores as a definitive global standard for low back pain disability. The data comes from a tiny number of studies, mostly in high-income clinical settings, so applying them to diverse populations or acute cases may be misleading.