{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:34:36Z","timestamp":1777466076625,"version":"3.51.4"},"reference-count":51,"publisher":"SAGE Publications","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMR"],"published-print":{"date-parts":[[2023,11,16]]},"abstract":"<jats:p>BACKGROUND: The effectiveness of physical therapy (PT) in patients with chronic non-specific low back pain (CNSLBP) is mainly evaluated through pain, disability, and health-related quality of life (HRQOL). However, recent studies have recommended the consideration of improvement from patients\u2019 perspectives. OBJECTIVE: This study aimed to investigate the relationship between the global perception of improvement in Lebanese patients with CNSLBP who have undergone PT, the HRQOL levels, as well as pain intensity. METHODS: 132 patients with CNSLBP who have undergone PT completed a questionnaire consisting of sociodemographic and CNSLBP characteristics questions, pain intensity numeric scale (NRS), 12-Item Short-Form Health Survey (SF-12), and the Global Perceived Effect scale (GPE). Binary logistic regressions and Pearson correlation coefficient were used for analyses. RESULTS: Global perceived improvement of PT varies according to HRQOL levels. A significant correlation was found between pain intensity after PT, perceived improvement from PT, and HRQOL. Educational level and pain irradiation have been shown to be predictive factors of perceived improvement after PT. CONCLUSION: Pain and HRQOL are interrelated and contributed to elucidating the global perception of improvement after PT in patients with CNSLBP. The findings suggest that patients\u2019 global perception of improvement should be considered in evaluating the benefits of physical therapy in addition to pain and HRQOL.<\/jats:p>","DOI":"10.3233\/bmr-220423","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T11:32:15Z","timestamp":1689679935000},"page":"1421-1428","source":"Crossref","is-referenced-by-count":2,"title":["Global perceived improvement and health-related quality of life after physical therapy in Lebanese patients with chronic non-specific low back pain"],"prefix":"10.1177","volume":"36","author":[{"given":"Nour El Hoda","family":"Saleh","sequence":"first","affiliation":[{"name":"Department of Research, Health, Rehabilitation, Integration, and Research Center (HRIR), Beirut, Lebanon"},{"name":"Physical Therapy Department, Faculty of Public Health, Islamic University of Lebanon, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yara","family":"Hamdan","sequence":"additional","affiliation":[{"name":"Physical Therapy Department, Faculty of Public Health, Islamic University of Lebanon, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Shabaanieh","sequence":"additional","affiliation":[{"name":"Physical Therapy Department, Faculty of Public Health, Islamic University of Lebanon, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nourhan","family":"Housseiny","sequence":"additional","affiliation":[{"name":"Physical Therapy Department, Faculty of Public Health, Islamic University of Lebanon, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Department of Research, Health, Rehabilitation, Integration, and Research Center (HRIR), Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aly Haj","family":"Diab","sequence":"additional","affiliation":[{"name":"Department of Research, Health, Rehabilitation, Integration, and Research Center (HRIR), Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Sadek","sequence":"additional","affiliation":[{"name":"Physical Therapy Department, Faculty of Public Health, Islamic University of Lebanon, Beirut, Lebanon"},{"name":"Physical Therapy Department, Faculty of Public Health, Lebanese University, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"issue":"9859","key":"10.3233\/BMR-220423_ref1","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1016\/S0140-6736(12)61729-2","article-title":"Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990\u20132010: a systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Vos","year":"2012","journal-title":"Lancet."},{"issue":"10070","key":"10.3233\/BMR-220423_ref2","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0140-6736(16)30970-9","article-title":"Non-specific low back pain","volume":"389","author":"Maher","year":"2017","journal-title":"The Lancet."},{"issue":"1","key":"10.3233\/BMR-220423_ref3","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1298\/ptr.E9937","article-title":"Effectiveness of classic physical therapy proposals for chronic non-specific low back pain: a literature review","volume":"21","author":"Cuenca-Mart\u00ednez","year":"2018","journal-title":"Phys Ther Res."},{"key":"10.3233\/BMR-220423_ref4","doi-asserted-by":"crossref","first-page":"j840","DOI":"10.1136\/bmj.j840","article-title":"Non-drug therapies should be first line treatment for low back pain, US guidance says","volume":"356","author":"McCarthy","year":"2017","journal-title":"Bmj."},{"issue":"7","key":"10.3233\/BMR-220423_ref5","doi-asserted-by":"crossref","first-page":"514","DOI":"10.7326\/M16-2367","article-title":"Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann Intern Med."},{"issue":"6","key":"10.3233\/BMR-220423_ref6","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.berh.2017.05.001","article-title":"Clinical guidelines for low back pain: A critical review of consensus and inconsistencies across three major guidelines","volume":"30","author":"O\u2019Connell","year":"2016","journal-title":"Best Pract Res Clin Rheumatol."},{"issue":"1","key":"10.3233\/BMR-220423_ref7","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1007\/s00586-017-5099-2","article-title":"National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy","volume":"27","author":"Stochkendahl","year":"2018","journal-title":"Eur Spine J."},{"issue":"2","key":"10.3233\/BMR-220423_ref8","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1002\/ejp.931","article-title":"Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration","volume":"21","author":"Wong","year":"2017","journal-title":"Eur J Pain."},{"issue":"11","key":"10.3233\/BMR-220423_ref9","doi-asserted-by":"crossref","first-page":"CPG1","DOI":"10.2519\/jospt.2021.0304","article-title":"Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021","volume":"51","author":"George","year":"2021","journal-title":"Journal of Orthopaedic & Sports Physical Therapy."},{"issue":"2","key":"10.3233\/BMR-220423_ref10","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s40122-018-0105-x","article-title":"Physical Therapy Approaches in the Treatment of Low Back Pain","volume":"7","author":"Shipton","year":"2018","journal-title":"Pain Ther."},{"key":"10.3233\/BMR-220423_ref11","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2147\/JPR.S171729","article-title":"Chronic low back pain and postural rehabilitation exercise: a literature review","volume":"12","author":"Paolucci","year":"2019","journal-title":"J Pain Res."},{"issue":"1","key":"10.3233\/BMR-220423_ref12","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s40122-020-00149-5","article-title":"Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions","volume":"9","author":"Pergolizzi","year":"2020","journal-title":"Pain Ther."},{"issue":"21-22","key":"10.3233\/BMR-220423_ref13","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1007\/s00508-019-1523-4","article-title":"Outcomes research in non-specific low back pain: Knowledge transfer in clinical practice","volume":"131","author":"Stamm","year":"2019","journal-title":"Wien Klin Wochenschr."},{"issue":"6","key":"10.3233\/BMR-220423_ref14","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1093\/ptj\/pzaa030","article-title":"How Do Physical Therapists Measure Treatment Outcomes in Adults With Chronic Low Back Pain? A Systematic Review","volume":"100","author":"Pires","year":"2020","journal-title":"Phys Ther."},{"issue":"2","key":"10.3233\/BMR-220423_ref15","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1080\/10400435.1996.10132278","article-title":"Outcomes measurement: health-related quality of life","volume":"8","author":"Oldridge","year":"1996","journal-title":"Assist Technol."},{"issue":"9","key":"10.3233\/BMR-220423_ref16","doi-asserted-by":"crossref","first-page":"2822","DOI":"10.1007\/s00586-016-4483-7","article-title":"Low back pain and health-related quality of life in community-dwelling older adults","volume":"25","author":"Cedraschi","year":"2016","journal-title":"Eur Spine J."},{"issue":"1","key":"10.3233\/BMR-220423_ref17","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s11136-019-02302-w","article-title":"The longitudinal relationships between pain severity and disability versus health-related quality of life and costs among chronic low back pain patients","volume":"29","author":"Mutubuki","year":"2020","journal-title":"Qual Life Res."},{"issue":"1","key":"10.3233\/BMR-220423_ref18","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1471-2474-7-5","article-title":"Active rehabilitation for chronic low back pain: Cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial [ISRCTN22714229]","volume":"7","author":"Smeets","year":"2006","journal-title":"BMC Musculoskelet Disord."},{"issue":"1","key":"10.3233\/BMR-220423_ref19","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1002\/art.24162","article-title":"Recovery: what does this mean to patients with low back pain","volume":"61","author":"Hush","year":"2009","journal-title":"Arthritis Rheum."},{"issue":"1-2","key":"10.3233\/BMR-220423_ref20","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.pain.2004.09.012","article-title":"Core outcome measures for chronic pain clinical trials: IMMPACT recommendations","volume":"113","author":"Dworkin","year":"2005","journal-title":"Pain."},{"issue":"7","key":"10.3233\/BMR-220423_ref21","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.jclinepi.2009.09.009","article-title":"Global Perceived Effect scales provided reliable assessments of health transition in people with musculoskeletal disorders, but ratings are strongly influenced by current status","volume":"63","author":"Kamper","year":"2010","journal-title":"J Clin Epidemiol."},{"issue":"6","key":"10.3233\/BMR-220423_ref22","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1002\/art.34347","article-title":"A systematic review of the global prevalence of low back pain","volume":"64","author":"Hoy","year":"2012","journal-title":"Arthritis Rheum."},{"issue":"11","key":"10.3233\/BMR-220423_ref23","doi-asserted-by":"crossref","first-page":"2791","DOI":"10.1007\/s00586-018-5673-2","article-title":"Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview","volume":"27","author":"Oliveira","year":"2018","journal-title":"Eur Spine J."},{"issue":"7","key":"10.3233\/BMR-220423_ref24","first-page":"421","article-title":"Mechanical Low Back Pain","volume":"98","author":"Will","year":"2018","journal-title":"Am Fam Physician."},{"issue":"3","key":"10.3233\/BMR-220423_ref25","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.jpain.2018.07.009","article-title":"Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain: A Systematic Review","volume":"20","author":"Chiarotto","year":"2019","journal-title":"J Pain."},{"issue":"16","key":"10.3233\/BMR-220423_ref26","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1097\/01.BRS.0000083317.62258.E6","article-title":"Behavioral graded activity following first-time lumbar disc surgery: 1-year results of a randomized clinical trial","volume":"28","author":"Ostelo","year":"2003","journal-title":"Spine (Phila Pa 1976)"},{"issue":"7168","key":"10.3233\/BMR-220423_ref27","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1136\/bmj.317.7168.1292","article-title":"Effectiveness of corticosteroid injections versus physiotherapy for treatment of painful stiff shoulder in primary care: randomised trial","volume":"317","author":"van der Windt","year":"1998","journal-title":"BMJ."},{"key":"10.3233\/BMR-220423_ref28","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1097\/01.brs.0000201293.57439.47","article-title":"Minimal Clinically Important Change for Pain Intensity, Functional Status, and General Health Status in Patients With Nonspecific Low Back Pain","volume":"31","author":"Roer","year":"2006","journal-title":"Spine."},{"issue":"8","key":"10.3233\/BMR-220423_ref29","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1097\/00007632-200404150-00011","article-title":"Responsiveness of pain, disability, and physical impairment outcomes in patients with low back pain","volume":"29","author":"Pengel","year":"2004","journal-title":"Spine."},{"issue":"1","key":"10.3233\/BMR-220423_ref30","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s13690-021-00579-3","article-title":"Validation of the Arabic version of the \u201c12-item short-form health survey\u201d (SF-12) in a sample of Lebanese adults","volume":"79","author":"Haddad","year":"2021","journal-title":"Arch Public Health."},{"issue":"5","key":"10.3233\/BMR-220423_ref31","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1136\/hrt.2003.013995","article-title":"Comparison of the short form (SF)-12 health status instrument with the SF-36 in patients with coronary heart disease","volume":"90","author":"M\u00fcller-Nordhorn","year":"2004","journal-title":"Heart."},{"issue":"3","key":"10.3233\/BMR-220423_ref32","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","article-title":"A 12-Item; Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity","volume":"34","author":"Ware","year":"1996","journal-title":"Med Care"},{"issue":"Suppl 11","key":"10.3233\/BMR-220423_ref33","first-page":"S383","article-title":"Adult measures of general health and health-related quality of life: Medical Outcomes Study Short Form 36-Item (SF-36) and Short Form 12-Item (SF-12) Health Surveys, Nottingham Health Profile (NHP), Sickness Impact Profile (SIP), Medical Outcomes Study Short Form 6D (SF-6D), Health Utilities Index Mark 3 (HUI3), Quality of Well-Being Scale (QWB), and Assessment of Quality of Life (AQoL)","volume":"63","author":"Busija","year":"2011","journal-title":"Arthritis Care Res (Hoboken)."},{"key":"10.3233\/BMR-220423_ref34","first-page":"171","article-title":"Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project","volume":"51","author":"Gandek","year":"1998","journal-title":"International Quality of Life Assessment. J Clin Epidemiol."},{"key":"10.3233\/BMR-220423_ref35","first-page":"421","article-title":"Assessment of validity and reliability of the Indonesian version of Short Form 12 (SF-12): Validity of the SF-12 in Indonesian adults","volume":"62","author":"Arovah","year":"2021","journal-title":"Journal of Preventive Medicine and Hygiene."},{"issue":"2","key":"10.3233\/BMR-220423_ref36","first-page":"108","article-title":"Reliability and Validity of the Turkish Version of SF-12 Health Survey","volume":"33","author":"Soylu","year":"2022","journal-title":"Turk Psikiyatri Derg."},{"issue":"1","key":"10.3233\/BMR-220423_ref37","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s13690-021-00579-3","article-title":"Validation of the Arabic version of the \u201c2-item short-form health survey\u201d (SF-12) in a sample of Lebanese adults","volume":"79","author":"Haddad","year":"2021","journal-title":"Archives of Public Health."},{"issue":"4","key":"10.3233\/BMR-220423_ref38","doi-asserted-by":"crossref","first-page":"293","DOI":"10.3109\/09593985.2014.994152","article-title":"Patients\u2019 and therapists\u2019 perception of change following physiotherapy in an orthopedic hospital\u2019s outpatient clinic","volume":"31","author":"Swanenburg","year":"2015","journal-title":"Physiother Theory Pract."},{"issue":"4","key":"10.3233\/BMR-220423_ref39","doi-asserted-by":"crossref","first-page":"e0175086","DOI":"10.1371\/journal.pone.0175086","article-title":"Physical activity level at work and risk of chronic low back pain: A follow-up in the Nord-Tr\u00f8ndelag Health Study","volume":"12","author":"Heuch","year":"2017","journal-title":"PLoS One."},{"issue":"1","key":"10.3233\/BMR-220423_ref40","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12891-019-2403-9","article-title":"Factors influencing disability in patients with chronic low back pain attending a tertiary hospital in sub-Saharan Africa","volume":"20","author":"Doualla","year":"2019","journal-title":"BMC Musculoskelet Disord."},{"issue":"4","key":"10.3233\/BMR-220423_ref41","doi-asserted-by":"crossref","first-page":"301","DOI":"10.5606\/tftrd.2019.3248","article-title":"The relationship of illness perceptions with demographic features, pain severity, functional capacity, disability, depression, and quality of life in patients with chronic low back pain","volume":"65","author":"\u00dcnal","year":"2019","journal-title":"Turk J Phys Med Rehabil."},{"key":"10.3233\/BMR-220423_ref42","doi-asserted-by":"crossref","unstructured":"Farrar JT, Young JP, Jr., LaMoreaux L, Werth JL, Poole MR. Clinical importance of changes in chronic pain intensity measured on an 11-point; numerical pain rating scale. Pain. 2001; 94(2): 149-58.","DOI":"10.1016\/S0304-3959(01)00349-9"},{"issue":"4","key":"10.3233\/BMR-220423_ref43","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.ejpain.2003.09.004","article-title":"Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale","volume":"8","author":"Salaffi","year":"2004","journal-title":"European Journal of Pain."},{"issue":"4","key":"10.3233\/BMR-220423_ref44","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1007\/s00586-013-3149-y","article-title":"\u201cI know it\u2019s changed\u201d: a mixed-methods study of the meaning of Global Perceived Effect in chronic neck pain patients","volume":"23","author":"Evans","year":"2014","journal-title":"European Spine Journal."},{"key":"10.3233\/BMR-220423_ref45","doi-asserted-by":"crossref","first-page":"102139","DOI":"10.1016\/j.msksp.2020.102139","article-title":"The role of pain and disability changes after physiotherapy treatment on global perception of improvement in patients with chronic low back pain","volume":"47","author":"Pires","year":"2020","journal-title":"Musculoskelet Sci Pract."},{"issue":"10","key":"10.3233\/BMR-220423_ref46","doi-asserted-by":"crossref","first-page":"e035445","DOI":"10.1136\/bmjopen-2019-035445","article-title":"Health-related quality of life and its determinants in patients with chronic low back pain at a tertiary hospital in Cameroon: a cross-sectional study","volume":"10","author":"Aminde","year":"2020","journal-title":"BMJ Open."},{"key":"10.3233\/BMR-220423_ref47","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1590\/S0103-21002013000100004","article-title":"Chronic low back pain: Pain intensity, disability and quality of life","volume":"26","author":"Stefane","year":"2012","journal-title":"Acta Paulista de Enfermagem."},{"key":"10.3233\/BMR-220423_ref48","first-page":"379","article-title":"Predictors of health-related quality of life and disability in patients with chronic non-specific Low back pain","volume":"80","author":"Klemenc-Keti\u0161","year":"2011","journal-title":"Zdravni\u0161ki Vestnik."},{"issue":"1","key":"10.3233\/BMR-220423_ref49","doi-asserted-by":"crossref","first-page":"30","DOI":"10.5606\/tftrd.2019.2373","article-title":"Effects of physical therapy agents on pain, disability, quality of life, and lumbar paravertebral muscle stiffness via elastography in patients with chronic low back pain","volume":"65","author":"Yurdakul","year":"2019","journal-title":"Turk J Phys Med Rehabil."},{"issue":"2","key":"10.3233\/BMR-220423_ref50","first-page":"143","article-title":"Predictors of response to exercise therapy for chronic low back pain: result of a prospective study with one year follow-up","volume":"50","author":"Cecchi","year":"2014","journal-title":"European Journal of Physical and Rehabilitation Medicine."},{"issue":"12","key":"10.3233\/BMR-220423_ref51","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.2522\/ptj.20130076","article-title":"Prognosis and course of disability in patients with chronic nonspecific low back pain: a 5- and 12-month follow-up cohort study","volume":"93","author":"Verkerk","year":"2013","journal-title":"Phys Ther."}],"container-title":["Journal of Back and Musculoskeletal Rehabilitation"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/BMR-220423","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:27:33Z","timestamp":1777382853000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/BMR-220423"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,16]]},"references-count":51,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3233\/bmr-220423","relation":{},"ISSN":["1878-6324","1053-8127"],"issn-type":[{"value":"1878-6324","type":"electronic"},{"value":"1053-8127","type":"print"}],"subject":[],"published":{"date-parts":[[2023,11,16]]}}}