Determinants of quality of life in individuals with chronic low back pain: a systematic review

Figures & data

Table 1. Risk of bias assessment (RoB 2).

	Randomisation	Effect of assignment to intervention	Effect of adhering to intervention	Risk of bias due to missing outcome data	Risk of bias in measurement of outcome	Risk of bias in selection of the reported results
Banth and Ardebil	Low	Low	Low	Low	Low	Low
Kofotolis et al.	Low	Low	Low	Low	Low	Low
Masumian et al.	Low	Low	Low	Low	Low	Low
Morone et al.	Low	Low	Low	Low	Low	Low
Natour et al.	Low	Low	Low	Low	Low	Low

Figure 1. PRISMA flow diagram.

Table 2. Study characteristics of the articles reviewed.

Authors, year, nationality	Study design	Participants (n)	Sample characteristics	Assessment tool	Determinants
Altuğ et al., 2016, Turkey	Cross-sectional study	112 patients	73 females & 39 males, CLBP > 3 months	VAS, IPAQ, TKS, ODI, SF-36	Kinesophobia (Significant negative relation with sub-parameters of SF-36)
Alaca et al., 2020, Turkey	Cross-sectional study	89 patients	47 males & 42 females, CLBP > 6 months	VAS, PBQ, TKS, ODI, SF-36	Kinesiophobia inverse correlation with mental health sub-dimension. Organic pain beliefs correlated with all sub-dimensions except physical limitation and role limitation. Psychological pain beliefs negative correlation with vitality and social function sub-dimension & positive correlation with mental health sub-dimension
Tsuji et al., 2018, Japan	Cross-sectional study	239	84 female & 155 male, CLBP> 3 months, employed	work productivity and activity impairment questionnaire, PHQ, SF-36	High presenteeism leading to impairments in HRQOL (P < 0.001)
Guclu et al., 2012, Turkey	Cross-sectional study	105	69 female, 36 male, CLBP for at least 3 months,	VAS, BAI, BDI, FABQ, SF-36, Rolland Morris Disability questionnaire	Pain severity, Fear avoidance (overall, physical and work), Anxiety – negative significant correlation with physical function, role function physical/emotional sub-dimensions of SF-36.
Comachio et al., 2018, Brazil	Cross-sectional study	132	40 males & 92 females, CLBP> 3 months	TSK, Rolland Morris questionnaire, McGill pain questionnaire, SF36	Kinesophobia correlated with physical and emotional role limitation.
Du et al., 2018, China	Cross-sectional study	221	127 females & 94 male, Pain for more than 3 months,	SES-6, FAB questionnaire, coping styles questionnaire, SF-36	Self-efficacy, Fear avoidance belief, active and passive coping predicting physical component summary of QOL. SE, passive coping and FAB predicting mental component summary of QOL.
Aminde et al., 2020, Cameroon	Cross-sectional study	136	Female: male =  1.8:1, CLBP > 3 months	VAS, WHOQOL-BREF, RMDQ	Higher perceived pain intensity, work absence, high score for disability, higher reported pain intensity, current smoking, duration of pain episode, education, income.
Stefane et al., 2013, Brazil	Cross-sectional study	97	67 female & 30 male,	RMDQ, WHOQOL Brief, 11 point scale of pain intensity,	Pain intensity weak negative correlation with physical domain of QOL. Disability has an inverse correlation to the physical domain and a moderate negative correlation with psychological domain of QOL.
Fujii et al., 2018, Japan	Cross-sectional study	3100	1483 female & 1617 male, CLBP> 3 months,	SSS-8, PHQ-2, EQ-5D-3L	Somatic symptoms scores were negatively correlated with QOL.
Huijnen et al., 2011, Netherlands	Cohort study	116		HSQ; 12, BDI, Baecke Physical Activity Questionnaire, RDQ, RAND-36,	Avoider activity related style has increased mental QOL.
Jung et al., 2018, South Korea	Cross-sectional study	108		VAS, ODI, SF-36, BDI,	Depression, sex, knee extension with dorsiflexion, and age
Mutubuki et al., 2020	Cohort study	6316	Female percentage =  66%	Numeric pain rating scale, ODI, EQ-5D-3L, cost questionnaire.	Pain intensity (negative relation), Disability (negative relation).
Sengul et al., 2010, Turkey	Cross-sectional study	113	41male& 72 female, CLBP> 3 months	VAS, ODI, MHLC, WHOQOL	Health locus of control. Internal health locus of control and chance locus of control.
Ketiš, 2011, Slovenia	Cross-sectional study	187	45.5% of men, CLBP lasted more than 3 months.	VAS, EQ-5D, ODI,Duke-AD	Higher level of chronic pain associated with lower QOL, presence of anxiety and depression,
Schaller et al., 2015, Germany	Cross-sectional study	412	96 males &316 females.	EQ-5D, GPAQ,	Moderate and rigorous workplace physical activity (negative association), Leisure time, pain intensity
Semeru & Halim, 2019, Indonesia	Cross-sectional study	52	43 females, 9 males	PDM,CPAQ-R, PCS, NEO FFI	Catastrophising positively related to QOL dimensions, Acceptance
Sezgin et al., 2015, Turkey	Cross-sectional study	200		SF-MPQ, FRI,SF 36, PSQI	Sleep quality (negative correlation with physical component summary scores)
Thomas et al., 2010, France	Cross-sectional study	50	Female % =  30%. CLBP for at least 3 months.	RMDQ, DPQ, FABQ, TSK, PCS, HAD.	Approximately 73% reporting impaired QOL. Psychosocial factors predict disability and QOL with catastrophising or kinesiophobia
Uchmanowicz et al., 2019, Poland	Cross-sectional study	100	chronic back pain lasting longer than 3 months	VAS, ESS, AIS, WHOQOL-BREF	Sex, age, place of residence, education, marital status, professional activity and duration of illness. Insomnia predicts QOL.
Ünal et al., 2019, Turkey	Cross-sectional study	114	86 females & 28 males, chronic back pain lasting longer than 3 months	IPQ-R, VAS, 6MWT, ODI, BDI, SF-36	Illness perception
Wettstein et al., 2019, Germany	Cross-sectional study	228	Female % =  71.5	MPI-D, PIS, SF-12, HADS-D	Age was associated with QOL related to mental health and well-being.

Table 3. Details of the intervention studies reviewed.

Authors, year, nationality	Study design	Participants (n)	Sample characteristics	Assessment tool	Interventions conducted
Banth & Ardebil, 2015, India	Pre-post quasi time series experimental design	88	Age 30–45 years females	McGill Pain questionnaire, Quality of life (SF-12),	MBSR has a significant impact on physical and mental QOL.
Kofotolis et al., 2016, Greece	Experimental design	101	Women aged 25–65 years,	SF 36	Patients given with Pilates exercises reported greater improvements in self-reported functional disability and health-related QOL.
Masumian et al., 2018, Iran	Pre-post-test experimental design with control group	18	Age 18–60 years	Multidimensional pain inventory, Five facet mindfulness questionnaire, FABQ	MBSR therapy is found to be effective in reducing fear avoidance belief
Morone et al., 2011, Italy	Randomised controlled trial	74		SF36, VAS, ODI,	Back school programme has produced significant improvement in several dimensions of SF36
Natour et al., 2015, Brazil	Randomised controlled trial	60		VAS, Rolland Morris questionnaire, SF36	Pilates method was found to be effective in improving dimensions of QOL

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