Distribution of psychological aspects in subgroups of chronic low back pain patients divided on the score of physical performance

This study investigates whether different subgroups of chronic low back pai n patients (CLBPs) differ in psychological aspects assessed with the Sympto m Checklist (SCL-90) and the Multidimensional Pain Questionnaire (MPI-DLV). Four subgroups of CLBPs are discerned using the results of lumbar dynamome try: 1. Patients with performances lower than healthy subjects (expected perform ance; n = 45). 2. Patients with performances comparable to healthy subject, (normal perfor mance; n = 18). 3. Patients with inconsistent test behaviour (submaximal performance; n = 6 ). 4. Patients with performances that could be either maximal or submaximal (g ray-zone performance; n = 10). Significant differences in psychological aspects were found between patient s with submaximal and patients with expected performances but not between p atients with normal and patients with expected performances. All patients w ith submaximal performance report a high degree of psychological distress, in contrast to 30% of those with normal performance and 20% of those with e xpected performance. Because of the differences found in psychological aspects between the CLBP subgroups, it is thought that a physical screening together with a psycholo gical screening provides better insight in the two aspects of the deconditi oning syndrome and thus can give better treatment indications than a physic al screening alone.