Cultural Influences on Chronic Low Back Pain: A Systematic Review with Indian Perspectives
DOI:
https://doi.org/10.69980/ajpr.v28i5.678Abstract
Background: Chronic low back pain (CLBP) contributes significantly to global disability, with prognostic models and clinical prediction rules (CPRs) aiding outcome prediction and treatment tailoring. Adherence to physiotherapy is critical but varies culturally, particularly in India, where kinesiophobia and joint family systems influence outcomes.
Objective: To synthesize evidence on prognostic models, CPRs, physiotherapy interventions, and adherence in adults with CLBP (2000–2025, with relevant 1997–1999 studies), emphasizing Indian perspectives.
Methods: This PRISMA-compliant systematic review searched PubMed, Cochrane Library, ClinicalTrials.gov, and Google Scholar. Studies on CLBP prognosis, CPRs, or adherence in adults were included. Data extraction covered study characteristics, cultural factors, outcomes, and models/adherence. Narrative synthesis and subgroup analyses compared Indian and global contexts. Risk of bias was assessed using NOS, RoB 2, AMSTAR-2, and CASP.
Results: From 470–520 records, 43 studies were included, with 11 prioritized: 5 on prognostic models/CPRs, 3 on adherence, and 3 on both. Mukasa and Sung (2020) (Mukasa & Sung, 2020) reported robust models for LBP onset (Harrell’s C 0.812) and recurrence (0.916). Kongsted et al.(2016) (Kongsted et al., 2016)showed low prognostic accuracy (AUC 0.50–0.61). Indian studies (Vaidya et al., 2023) highlighted kinesiophobia as an adherence barrier. The Enhanced LBP Risk Score Calculator integrates risk prediction, subgrouping, and cultural factors.
Conclusion: Prognostic models and adherence strategies are promising but require validation, especially in India.
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