Biodisabilities in relation to other disease consequences in the functional assessment of patients with chronic low back pain

The theoretical assumptions concerning the assessment of some physical disease consequences according to the Biopsychosocial Dimensional Classification (BPSDC) model were tested in patients with chronic low back pain. Factor analyses showed that the mutual relations of selected measures for biodisabilities, as well as their relationship to some measures of bioimpairments, and bio- and psycho-handicaps supported many of the original assumptions of the BPSDC model. For instance, several dynamometer and non-dynamometer measures of physical capacity and performance associated themselves with the factor of 'physical fitness' interpreted to represent disabilities. A very interesting observation was that the subjective experiences of pain intensity, pain interference and management in various physical activities assessed by self-reports, represented the psycho-axis instead of the bio-axis. Another interesting notion was that the measures for organic pathology, i.e. 'neuromuscular findings' and 'spinal findings', separated themselves from other factors, and were interpreted to represent bio-impairments. Additionally, the range of motion measures in active movements and body positions were related to organic pathology, and were thus interpreted to bio-impairments, not disabilities as previously thought. It is emphasized that in order to know about the clinical meaningfulness of the dimensions found, further studies about the predictive value of the factors should be performed.