Research Fellow and Group Leader, NeuRA
Conjoint Senior Lecturer, Faculty of Medicine, UNSW
Honorary Research Fellow, The George Institute for Global Health
+612 9399 1266
Dr McAuley is a Research Fellow and group leader of the McAuley Pain Group at NeuRA. He has been researching low back pain for 12 years, since he obtained his PhD from Brunel University UK in 2002. After immigrating to Australia in 2004 he took up a post doc at the University of Sydney with Profs Chris Maher and Kathryn Refshauge and then at the George Institute for Global Health. In 2010 he jointed Prof Moseley at NeuRA and was appointed group leader in 2014.
DR MARKUS HUEBSCHER Postdoctoral Fellow
DR MARTIN RABEY Research Assistant
HOPIN LEE PhD candidate
: +61 2 9399 1049
ADRIAN TRAEGER PhD candidate
AUDREY WANG PhD candidate
Disability is an important outcome from a clinical and public health perspective. However, it is unclear how disability develops in people with low back pain or neck pain. More specifically, the mechanisms by which pain leads to disability are not well understood. Mediation analysis is a way of investigating these mechanisms by examining the extent to which an intermediate variable explains the effect of an exposure on an outcome. This systematic review and meta-analysis aimed to identify and examine the extent to which putative mediators explain the effect of pain on disability in people with low back pain or neck pain. Five electronic databases were searched. We found 12 studies (N = 2961) that examined how pain leads to disability with mediation analysis. Standardized regression coefficients (β) of the indirect and total paths were pooled. We found evidence to show that self-efficacy (β = 0.23, 95% confidence interval [CI] = 0.10 to 0.34), psychological distress (β = 0.10, 95% CI = 0.01 to 0.18), and fear (β = 0.08, 95% CI = 0.01 to 0.14) mediated the relationship between pain and disability, but catastrophizing did not (β = 0.07, 95% CI = -0.06 to 0.19). The methodological quality of these studies was low, and we highlight potential areas for development. Nonetheless, the results suggest that there are significant mediating effects of self-efficacy, psychological distress, and fear, which underpins the direct targeting of these constructs in treatment.
To determine whether patient education in primary care increases reassurance in patients with acute or subacute low back pain (LBP). There is moderate- to high-quality evidence that patient education in primary care can provide long-term reassurance for patients with acute or subacute LBP.