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How Individuals With Low Back Pain Conceptualize Their Condition: A Collaborative Modeling Approach

  • Paul W Hodges
    Correspondence
    Address for reprint requests to: Paul Hodges, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane QLD 4072 Australia.
    Affiliations
    The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, Brisbane, Australia
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  • Jenny Setchell
    Affiliations
    The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, Brisbane, Australia
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  • Emily Daniel
    Affiliations
    The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, Brisbane, Australia
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  • Matt Fowler
    Affiliations
    The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, Brisbane, Australia
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  • Angela S Lee
    Affiliations
    Michigan State University, Center for Neuromusculoskeletal Clinical Research, Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, East Lansing, Michigan
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  • John M Popovich Jr.
    Affiliations
    Michigan State University, Center for Neuromusculoskeletal Clinical Research, Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, East Lansing, Michigan
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  • Jacek Cholewicki
    Affiliations
    Michigan State University, Center for Neuromusculoskeletal Clinical Research, Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, East Lansing, Michigan
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Published:January 16, 2022DOI:https://doi.org/10.1016/j.jpain.2021.12.014

      Highlights

      • We used collaborative modeling to evaluate how LBP patients conceptualize their condition.
      • Patients created mental models with greatest weight on biomechanical factors.
      • Patient views contrast the psychological bias of clinicians and researchers.
      • Mental models can be used as a possible method to understand how patients view their condition.

      Abstract

      Low back pain (LBP) is complex. This study aimed to use collaborative modeling to evaluate conceptual models that individuals with LBP have of their condition, and to compare these models with those of researchers/clinicians. Twenty-eight individuals with LBP were facilitated to generate mental models, using “fuzzy cognitive maps,” that represented conceptualization of their own LBP and LBP “in general.” “Components” (ie, causes, outcomes and treatments) related to pain, disability and quality of life were proposed, along with the weighted “Connections” between Components. Components were classified into thematic categories. Weighting of Connections were summed for each Component to judge relative importance. Individual models were aggregated into a metamodel. When considering their own condition, participants’ models included 19(SD = 6) Components and 43(18) Connections with greatest weight on “Biomechanical” components. When considering LBP in general, models changed slightly. Patient models contrasted the more complex models of researchers/clinicians (25(7) Components; 77(42) Connections), with most weight on “Psychological” components. This study provides unique insight into how individuals with LBP consider their condition, which is largely biomedical and narrower than clinician/researcher perspectives. Findings highlight challenges for changing public perception of LBP, and provide a method with potential utility to understand how individuals conceptualize their condition.

      Perspective

      Collaborative modeling was used to understand how individuals with low back pain conceptualize their own condition, the condition in general, and compare this with models of expert researchers/clinicians. Data revealed issues in how individuals with back pain conceptualize their condition, and the method's potential utility for clinical evaluation of patients.

      Keywords

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