{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T22:53:28Z","timestamp":1784760808610,"version":"3.55.0"},"reference-count":101,"publisher":"BMJ","issue":"3","funder":[{"name":"Tertiary Education Trust fund, University of Nigeria"},{"DOI":"10.13039\/100002322","name":"Schlumberger Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2017,6,28]]},"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Many people in Nigeria are living with disability due to chronic low back pain (CLBP), with the greatest burden accounted for by people living in rural Nigeria. However, factors associated with disability in rural Nigeria have not yet been established. We investigated the biomechanical and psychosocial predictors of CLBP disability in a rural Nigerian population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A cross-sectional study of adults with non-specific CLBP recruited from rural communities in Enugu State, South-eastern Nigeria. Measures of self-reported and performance-based disability, pain intensity, anxiety and depression, coping strategies, social support, occupational biomechanical factors, illness perceptions and fear avoidance beliefs were collected by trained community health workers. We used univariate and multivariate analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>200 individuals were recruited. Psychosocial factors were the most important factors associated with CLBP disability, and accounted for 62.5% and 49.1% of the variance in self-reported and performance-based disability, respectively. The significant predictors of self-reported disability were: illness perceptions (\u03b2=0.289; p&lt;0.0005), pain intensity (\u03b2=0.230; p&lt;0.0005), catastrophising (\u03b2=0.210; p=0.001), fear avoidance beliefs (\u03b2=0.198; p=0.001) and anxiety (\u03b2=0.154; p=0.023). The significant predictors of performance-based disability were: illness perceptions (\u03b2=0.366; p&lt;0.0005), social support (\u03b2=0.290; p&lt;0.0005), fear avoidance beliefs (\u03b2=0.189; p&lt;0.01) and female gender (\u03b2=0.184; p&lt;0.01). Illness concern was the most salient dimension of illness perceptions predicting self-reported and performance-based disability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These results provide evidence which can be used to inform the development of interventions to reduce CLBP disability in rural Nigeria, and may have relevance in other rural African contexts.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjgh-2017-000284","type":"journal-article","created":{"date-parts":[[2017,9,16]],"date-time":"2017-09-16T20:10:15Z","timestamp":1505592615000},"page":"e000284","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":61,"title":["Biopsychosocial factors associated with chronic low back pain disability in rural Nigeria: a population-based cross-sectional study"],"prefix":"10.1136","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8021-0283","authenticated-orcid":false,"given":"Chinonso Nwamaka","family":"Igwesi-Chidobe","sequence":"first","affiliation":[{"name":"Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria (Enugu Campus), Nsukka, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bolaji","family":"Coker","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre at Guy\u2019s and St Thomas\u2019, NHS Foundation Trust and King\u2019s College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chika N","family":"Onwasigwe","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac O","family":"Sorinola","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, School of Population Health Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma L","family":"Godfrey","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, School of Population Health Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,9,15]]},"reference":[{"key":"2025072913371075000_2.3.e000284.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60692-4"},{"key":"2025072913371075000_2.3.e000284.2","doi-asserted-by":"publisher","DOI":"10.1002\/art.34347"},{"key":"2025072913371075000_2.3.e000284.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2009.11.002"},{"key":"2025072913371075000_2.3.e000284.4","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205393"},{"key":"2025072913371075000_2.3.e000284.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2010.10.002"},{"key":"2025072913371075000_2.3.e000284.6","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/S0140-6736(03)12254-4","article-title":"Low back pain in rural Tibet","volume":"361","author":"Hoy","year":"2003","journal-title":"The Lancet"},{"key":"2025072913371075000_2.3.e000284.7","doi-asserted-by":"crossref","first-page":"449","DOI":"10.2340\/16501977-2083","article-title":"Everyday burden of musculoskeletal conditions among villagers in rural Botswana: A focused ethnography","volume":"48","author":"Hondras","year":"2016","journal-title":"J Rehabil Med"},{"key":"2025072913371075000_2.3.e000284.8","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-8-105"},{"key":"2025072913371075000_2.3.e000284.9","doi-asserted-by":"publisher","DOI":"10.1177\/004947550403400107"},{"key":"2025072913371075000_2.3.e000284.10","first-page":"259","article-title":"Prevalence of low back pain among peasant farmers in a rural community in South West Nigeria","volume":"34","author":"Fabunmi","year":"2005","journal-title":"Afr J Med Med Sci"},{"key":"2025072913371075000_2.3.e000284.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)01312-4"},{"key":"2025072913371075000_2.3.e000284.12","doi-asserted-by":"crossref","first-page":"621","DOI":"10.2478\/s13382-013-0135-x","article-title":"Prevalence and impacts of low back pain among peasant farmers in south-west Nigeria","volume":"26","author":"Tella","year":"2013","journal-title":"Int J Occup Med Environ Health"},{"key":"2025072913371075000_2.3.e000284.13","doi-asserted-by":"crossref","unstructured":"Birabi BN , Dienye PO , Ndukwu GU . 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