Marco Campello, Ph.D.

Factors predicting clinical outcome 12 and 36 months after an exercise intervention for recurrent low-back pain
Rasmussen-Barr, Eva; Campello, Marco; Arvidsson, Inga; Nilsson-Wikmar, Lena; Ang, Bjorn-Olov
2012 JAN ;34(2):136-144, Disability & rehabilitation
Purpose: The aim of this cohort study was to identify early predictive factors for a poor outcome of disability and pain 12- and 36-months after an intervention in patients with recurrent low-back pain, currently at work. Method: Seventy-one patients with recurrent low-back pain, all at work, seeking care in a primary health care setting were included. Predictive indicators including demographic data and health-related variables were derived from questionnaires pre- and post intervention over eight weeks. The dependent outcome variables were perceived disability and present pain at 12- and 36-months. Results: Multivariate regression analyses show that early data on poor self-efficacy for physical activity, greater disability, and higher level of pain-ratings emerged as independent predictors of a poor outcome of disability at 12 and 36 months. Higher ratings of pain and poor self-efficacy appeared again as independent predictors of a poor outcome of pain at the 12-month follow-up. Pain frequency ratings predicted a poor outcome of pain at 36 months. Conclusions: Our results suggest that ratings of poor self-efficacy for physical activity, greater disability, and pain-ratings, are the most consistent independent predictors of long-term poor outcome of disability and pain. This indicates the importance of screening for such factors to optimize the management of low-back pain. However, larger studies in similar patient populations are needed to confirm these results
— id: 149729, year: 2012, vol: 34, page: 136, stat: Journal Article,

Nonspecific low back pain
Hiebert R; Weiser S; Campello M; Nordin M
Environmental and occupational medicine Philadelphia : Wolters Kluwer/Lippincott Williams & Wilkins, 2007,
— id: 4809, year: 2007, vol: , page: 924, stat: Chapter,

Self-care techniques for acute episodes of back pain
Weiser S; Campello M; Nordin M; Pietrek M
Pain : best practice & research compendium Edinburgh : Elsevier, 2007,
— id: 4808, year: 2007, vol: , page: 83, stat: Chapter,

Work retention and nonspecific low back pain
Campello, Marco A; Weiser, Sherri R; Nordin, Margareta; Hiebert, Rudi
2006 Jul 15;31(16):1850-1857, Spine
STUDY DESIGN: A cohort study of patients with nonspecific low back pain (LBP) participated in a 4-week multidisciplinary rehabilitation program. OBJECTIVE: To identify factors that predict work retention 24 months after treatment in patients with nonspecific LBP. SUMMARY OF BACKGROUND DATA: There is evidence that select physical, psychologic, and psychosocial factors are related to positive outcome for work-related nonspecific LBP. However, there is very little information related to work retention following an episode of nonspecific LBP. This is an exploratory study to identify select physical and psychosocial factors related to work retention. METHODS: Patients who returned to work after treatment (n = 67) were followed for 2 years. Physical baseline measures included tests of flexibility, strength, and functional capacity. Psychosocial baseline measures were The Symptoms Checklist 90-R, The Pain Beliefs and Perceptions Inventory, The Oswestry Scale of perceived disability, The Work Stress Inventory, and The Quality of Life Scale. All physical parameters, perceived disability, and quality of life were tested before and after treatment. The dependent variable, work retention, was defined as the number of days that the subject worked during the 2-year follow-up period. Survival analysis was used to establish the predictive model. RESULT: The average time out of work before treatment was 9 months (standard deviation 12.8) for 67 subjects (mean age 40 years [standard deviation 9.6]), including 18 females and 49 males. There were 18 participants (25%) that had interruption of work retention at follow-up. Average work retention was 362 days (range 47-682). Variables that reached a P value of <0.10 in the bivariate analysis were included in the multivariate analysis. They were trunk flexion (hazard ratio [HR = 2.4], 95% confidence interval [CI] 1.24-4.38; P = 0.01), trunk extension (HR = 2.1, 95% CI 1.02-4.16; P = 0.04), the somatization scale from the Symptom Checklist 90 revised (HR = 2.0, 95% CI 1.03-4.05; P = 0.04), and the obsessive-compulsiveness scale from the Symptom Checklist 90 revised (HR = 0.4, 95% CI 0.12-1.15; P = 0.09). Results showed that post-test trunk flexion, somatization, and obsessive compulsiveness predicted work retention (final trunk flexion HR = 2.5 [95% CI 1.26-4.79; P = 0.01], somatization scale HR = 2.5 [95% CI 1.25-4.93; P = 0.01], and obsessive compulsion HR = 0.2 [95% CI 0.07-0.77; P = 0.02]). CONCLUSION: Psychosocial and physical factors are associated with work retention for patients with nonspecific LBP. The predictive value of certain constructs may vary with the time when they are assessed and how outcome is operationalized. Further studies are needed to confirm these findings
— id: 67009, year: 2006, vol: 31, page: 1850, stat: Journal Article,

Restoring patients with nonspecific low back pain to gainful employment
Wesiser S; Campello M; Nordin M; Hiebert R
Rothman-Simeone the spine Philadelphia : Saunders Elsevier, 2006,
— id: 4555, year: 2006, vol: , page: 1595, stat: Chapter,

Non-specific low back pain : current issues in treatment
Nordin M; Lis A; Weiser S; Campello M
The adult and pediatric spine Philadelphia : Lippincott Williams & Wilkins, 2004,
— id: 4556, year: 2004, vol: , page: 307, stat: Chapter,

Measures for low back pain: a proposal for clinical use
Nordin, Margareta; Alexandre, Neusa Maria Costa; Campello, Marco
2003 Mar-Apr;11(2):152-155, Revista latino-americana de enfermagem
Low back pain represents a serious public health problem. Therefore, great efforts have been made in order to improve and assess the efficacy of its treatment. Reports in international literature have presented important studies concerning instruments to assess pain and functional incapacity in patients with low back pain. This study presents a clinical protocol which was developed by a multidisciplinary team. This protocol consists of the evaluation and distribution of pain, The Spitzer Quality of Life, The Oswestry Low Back Pain Disability Questionnaire, and The Center for Epidemiological Studies Depression Scale. Instruments must be urgently developed or adapted in order to be used according to the Brazilian reality
— id: 39144, year: 2003, vol: 11, page: 152, stat: Journal Article,

Predictors of compliance with short-term treatment among patients with back pain
Alexandre, Neusa Maria Costa; Nordin, Margareta; Hiebert, Rudi; Campello, Marco
2002 Aug;12(2):86-94, Revista panamericana de salud publica = Pan American journal of public health
OBJECTIVE: Great efforts have been made to find effective treatments for back pain. Nevertheless, the effectiveness of a particular treatment can depend on patient compliance. The objective of this study was to prospectively investigate whether patients' demographic factors, clinical factors, external barriers in following the treatment, and perceptions of disability, quality of life, depression, and control over health were predictive of compliance with a physical therapy program carried out with patients with low back pain. METHODS: This was an exploratory prospective cohort study that was carried out in New York City during 1999. All study participants answered a questionnaire at the initial clinical evaluation by a physical therapist and were followed during the treatment. The study assessed compliance with the three treatment regimens that were prescribed for every patient: attending scheduled physical therapy sessions, following a program of home exercises, and watching back-education videotapes. Depending on the individual patient, the planned treatment program could last from 2 to 6 weeks. The study employed a battery of instruments to measure patient characteristics that included perceived functional limitations, perceived quality of life, depression, and their beliefs about their health. Student's t tests and chi-square tests were used to determine if non- and low-compliant patients differed significantly from high-compliant patients. Logistic regression was used to estimate adjusted odds ratios expressing the association of selected variables with compliance. RESULTS: We found that 51% of the patients were either noncompliant or low-compliant overall with the low back pain treatment program. There were differences in compliance behavior among the three treatment regimens, with compliance being highest for watching the back-education videotapes and lowest for doing the home exercises. Poor compliance overall was positively associated with the expectation of barriers in following the proposed treatment, with comorbidity, and with longer duration of treatment in this program. CONCLUSIONS: The findings of our study indicate that patient compliance with back pain treatment is a serious and complex problem. Nevertheless, while this study was only an exploratory one, we believe that the results of this study can be used by care providers to identify patients likely to become noncompliant and also by researchers to plan specific studies on the effectiveness of treatment programs for patients with low back pain
— id: 72178, year: 2002, vol: 12, page: 86, stat: Journal Article,

Self-care techniques for acute episodes of low back pain
Nordin, Margareta; Welser, Sherri; Campello, Marco A; Pietrek, Markus
2002 Jan;16(1):89-104, Bailliere's best practice & research. Clinical rheumatology
Guidelines recommend minimal medical intervention for acute non-specific low back pain. However, patients often request strategies to reduce symptoms and recover quickly. Self-care techniques that do not contradict current evidence-based recommendations may be suggested. Self-care techniques can reduce costs and iatrogenic complications that can occur with medical treatment. They may also increase the patient's perception of control and improve long-term outcome. A shift in paradigm for the health care provider and the patient is required for self-care to be successful. These issues, as well as self-care approaches such as medication, exercises, modalities and mind-body techniques are discussed. Practice points for each approach are given
— id: 39657, year: 2002, vol: 16, page: 89, stat: Journal Article,

Physical therapy: exercises and the modalities: when, what, and Why?
Nordin M; Campello M
1999 Feb;17(1):75-89, Neurologic clinics
This article reviews the evidence for using modalities and/or exercise treatment in patients with nonspecific low back pain. Poor evidence of efficacy exists for the use of modalities in this patient group. Exercises are beneficial for patients with subacute and chronic nonspecific low back pain. Further studies are needed for type, frequency, duration, and intensity of exercises
— id: 7416, year: 1999, vol: 17, page: 75, stat: Journal Article,

Approaches to improve the outcome of patients with delayed recovery
Campello M; Weiser S; van Doorn JW; Nordin M
1998 Feb;12(1):93-113, Bailliere's clinical rheumatology
The purpose of this chapter is to promote a model to prevent chronicity and disability from non-specific low back pain (NSLBP). Delayed recovery is defined in this chapter as the period between 4 and 8 weeks after onset of NSLBP during which a patient has not yet returned to work. The recognition of predictors associated with delayed recovery at onset of the problem helps health care providers in their treatment plan. An algorithm can be useful for health care providers and employers in guiding the employee back to work. A multidisciplinary return to work programme is an essential part of the algorithm
— id: 7518, year: 1998, vol: 12, page: 93, stat: Journal Article,

Early predictors of delayed return to work in patients with low back pain
Nordin M; Skovron ML; Hiebert R; Weiser S; Brisson PM; Campello M; Harwood K; Crane M; Lewis S
1997 ;5(2):5-27, Journal of Musculoskeletal Pain
— id: 80324, year: 1997, vol: 5, page: 5, stat: Journal Article,

Physical exercise and low back pain
Campello M; Nordin M; Weiser S
1996 Apr;6(2):63-72, Scandinavian journal of medicine & science in sports
Health care providers often prescribe exercises as treatment for nonspecific low back pain. However, the effectiveness of this treatment is poorly documented in the literature. While the evidence suggests that exercise in general is beneficial, there is a lack of knowledge about the types, frequency and duration of exercises that should be prescribed and at what stage of injury they are most helpful. In addition, few studies have dealt with exercise treatment alone rather than in combination with other treatments, making it hard to decipher the unique contribution of exercise. Inadequate study designs also make conclusions difficult. Conversely, the literature clearly shows that inactivity has detrimental effects (i.e. delayed return to normal activity, and negative physiological and psychological effects) for low back pain patients
— id: 12622, year: 1996, vol: 6, page: 63, stat: Journal Article,

Exercises for the patient with low back pain: when and how
Nordin M; Campello M; Weiser S
1996 ;55(3):142-146, Bulletin (Hospital for Joint Diseases)
— id: 12670, year: 1996, vol: 55, page: 142, stat: Journal Article,

Early predictors of outcome
Nordin M; Skovron ML; Hiebert R; Weiser S; Brisson PM; Campello M; Crane M; Lewis S
1996 ;55(4):204-206, Bulletin (Hospital for Joint Diseases)
— id: 12668, year: 1996, vol: 55, page: 204, stat: Journal Article,