Treatment of chronic low back pain: a randomized, clinical trial comparing group-based multidisciplinary biopsychosocial rehabilitation and intensive individual therapist-assisted back muscle strengthening exercises

Ninna Dufour; Gorm Thamsborg; Alex Oefeldt; Charlotte Lundsgaard; Steen Stender

doi:10.1097/BRS.0b013e3181b8db2e

Treatment of chronic low back pain: a randomized, clinical trial comparing group-based multidisciplinary biopsychosocial rehabilitation and intensive individual therapist-assisted back muscle strengthening exercises

Ninna Dufour, Gorm Thamsborg, Alex Oefeldt, Charlotte Lundsgaard, Steen Stender

62 Citationer (Scopus)

Abstract

Study Design: A stratified randomized single-blinded clinical trial. Objective: To compare the efficacies of 2 active therapies for chronic low back pain (CLBP). Summary of Background Data: Both a multidisciplinary biopsychosocial rehabilitation program and an intensive individual therapist-assisted back muscle strengthening exercise program used in Denmark have been reported to be effective for the treatment of CLBP. Methods: A total of 286 patients with CLBP were randomized to either a group-based 12-week program comprising 73 hours of therapist exposure (approximately 12 h/patient): 35 hours of hard physical exercise, 22 hours of light exercise/occupational therapy, and 16 hours of education (group A) or a 12-week program comprising 1 hour of personal training twice a week, i.e., therapist exposure 24 h/patient (group B). At baseline and at 3, 6, 12, and 24 months, patients filled out questionnaires on pain (visual analogue scale [VAS]-pain average, which was the primary outcome measure), Roland-Morris disability questionnaire, global perceived outcome, and 36-Item Short-Form General Health Survey. Data were analyzed using the intention-to-treat principle. Results: of the 286 patients, 14 patients did not start treatment. of the remaining patients, 25 (9%) dropped out of therapy. The 2 groups were comparable regarding baseline characteristic. After treatment, significant improvements were observed with regard to pain, disability, and most of the quality of life dimensions. These effects were sustained over the 24-month follow-up period. There were some statistically significant differences between the 2 groups relating to secondary end points, Roland-Morris disability questionnaire, and in the MOS 36-Item Short-Form Health Survey the "physical functioning" dimension and the "physical component Summary." Conclusion: Both groups showed long-term improvements in pain and disability scores, with only minor statistically significant differences between the 2 groups. The minor outcome difference in favor of the group-based multidisciplinary rehabilitation program is hardly of clinical interest for individual patients.

Originalsprog	Engelsk
Tidsskrift	Spine Rehabilitation
Vol/bind	35
Udgave nummer	5
Sider (fra-til)	469-76
Antal sider	8
DOI	https://doi.org/10.1097/BRS.0b013e3181b8db2e
Status	Udgivet - 1 mar. 2010

Adgang til dokumentet

10.1097/BRS.0b013e3181b8db2e

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Citationsformater

Dufour, N., Thamsborg, G., Oefeldt, A., Lundsgaard, C., & Stender, S. (2010). Treatment of chronic low back pain: a randomized, clinical trial comparing group-based multidisciplinary biopsychosocial rehabilitation and intensive individual therapist-assisted back muscle strengthening exercises. Spine Rehabilitation, 35(5), 469-76. https://doi.org/10.1097/BRS.0b013e3181b8db2e

Treatment of chronic low back pain: a randomized, clinical trial comparing group-based multidisciplinary biopsychosocial rehabilitation and intensive individual therapist-assisted back muscle strengthening exercises. / Dufour, Ninna; Thamsborg, Gorm; Oefeldt, Alex et al.
I: Spine Rehabilitation, Bind 35, Nr. 5, 01.03.2010, s. 469-76.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Dufour, N, Thamsborg, G, Oefeldt, A, Lundsgaard, C & Stender, S 2010, 'Treatment of chronic low back pain: a randomized, clinical trial comparing group-based multidisciplinary biopsychosocial rehabilitation and intensive individual therapist-assisted back muscle strengthening exercises', Spine Rehabilitation, bind 35, nr. 5, s. 469-76. https://doi.org/10.1097/BRS.0b013e3181b8db2e

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title = "Treatment of chronic low back pain: a randomized, clinical trial comparing group-based multidisciplinary biopsychosocial rehabilitation and intensive individual therapist-assisted back muscle strengthening exercises",

abstract = "Study Design: A stratified randomized single-blinded clinical trial. Objective: To compare the efficacies of 2 active therapies for chronic low back pain (CLBP). Summary of Background Data: Both a multidisciplinary biopsychosocial rehabilitation program and an intensive individual therapist-assisted back muscle strengthening exercise program used in Denmark have been reported to be effective for the treatment of CLBP. Methods: A total of 286 patients with CLBP were randomized to either a group-based 12-week program comprising 73 hours of therapist exposure (approximately 12 h/patient): 35 hours of hard physical exercise, 22 hours of light exercise/occupational therapy, and 16 hours of education (group A) or a 12-week program comprising 1 hour of personal training twice a week, i.e., therapist exposure 24 h/patient (group B). At baseline and at 3, 6, 12, and 24 months, patients filled out questionnaires on pain (visual analogue scale [VAS]-pain average, which was the primary outcome measure), Roland-Morris disability questionnaire, global perceived outcome, and 36-Item Short-Form General Health Survey. Data were analyzed using the intention-to-treat principle. Results: of the 286 patients, 14 patients did not start treatment. of the remaining patients, 25 (9%) dropped out of therapy. The 2 groups were comparable regarding baseline characteristic. After treatment, significant improvements were observed with regard to pain, disability, and most of the quality of life dimensions. These effects were sustained over the 24-month follow-up period. There were some statistically significant differences between the 2 groups relating to secondary end points, Roland-Morris disability questionnaire, and in the MOS 36-Item Short-Form Health Survey the {"}physical functioning{"} dimension and the {"}physical component Summary.{"} Conclusion: Both groups showed long-term improvements in pain and disability scores, with only minor statistically significant differences between the 2 groups. The minor outcome difference in favor of the group-based multidisciplinary rehabilitation program is hardly of clinical interest for individual patients.",

author = "Ninna Dufour and Gorm Thamsborg and Alex Oefeldt and Charlotte Lundsgaard and Steen Stender",

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T1 - Treatment of chronic low back pain: a randomized, clinical trial comparing group-based multidisciplinary biopsychosocial rehabilitation and intensive individual therapist-assisted back muscle strengthening exercises

AU - Dufour, Ninna

AU - Thamsborg, Gorm

AU - Oefeldt, Alex

AU - Lundsgaard, Charlotte

AU - Stender, Steen

PY - 2010/3/1

Y1 - 2010/3/1

N2 - Study Design: A stratified randomized single-blinded clinical trial. Objective: To compare the efficacies of 2 active therapies for chronic low back pain (CLBP). Summary of Background Data: Both a multidisciplinary biopsychosocial rehabilitation program and an intensive individual therapist-assisted back muscle strengthening exercise program used in Denmark have been reported to be effective for the treatment of CLBP. Methods: A total of 286 patients with CLBP were randomized to either a group-based 12-week program comprising 73 hours of therapist exposure (approximately 12 h/patient): 35 hours of hard physical exercise, 22 hours of light exercise/occupational therapy, and 16 hours of education (group A) or a 12-week program comprising 1 hour of personal training twice a week, i.e., therapist exposure 24 h/patient (group B). At baseline and at 3, 6, 12, and 24 months, patients filled out questionnaires on pain (visual analogue scale [VAS]-pain average, which was the primary outcome measure), Roland-Morris disability questionnaire, global perceived outcome, and 36-Item Short-Form General Health Survey. Data were analyzed using the intention-to-treat principle. Results: of the 286 patients, 14 patients did not start treatment. of the remaining patients, 25 (9%) dropped out of therapy. The 2 groups were comparable regarding baseline characteristic. After treatment, significant improvements were observed with regard to pain, disability, and most of the quality of life dimensions. These effects were sustained over the 24-month follow-up period. There were some statistically significant differences between the 2 groups relating to secondary end points, Roland-Morris disability questionnaire, and in the MOS 36-Item Short-Form Health Survey the "physical functioning" dimension and the "physical component Summary." Conclusion: Both groups showed long-term improvements in pain and disability scores, with only minor statistically significant differences between the 2 groups. The minor outcome difference in favor of the group-based multidisciplinary rehabilitation program is hardly of clinical interest for individual patients.

AB - Study Design: A stratified randomized single-blinded clinical trial. Objective: To compare the efficacies of 2 active therapies for chronic low back pain (CLBP). Summary of Background Data: Both a multidisciplinary biopsychosocial rehabilitation program and an intensive individual therapist-assisted back muscle strengthening exercise program used in Denmark have been reported to be effective for the treatment of CLBP. Methods: A total of 286 patients with CLBP were randomized to either a group-based 12-week program comprising 73 hours of therapist exposure (approximately 12 h/patient): 35 hours of hard physical exercise, 22 hours of light exercise/occupational therapy, and 16 hours of education (group A) or a 12-week program comprising 1 hour of personal training twice a week, i.e., therapist exposure 24 h/patient (group B). At baseline and at 3, 6, 12, and 24 months, patients filled out questionnaires on pain (visual analogue scale [VAS]-pain average, which was the primary outcome measure), Roland-Morris disability questionnaire, global perceived outcome, and 36-Item Short-Form General Health Survey. Data were analyzed using the intention-to-treat principle. Results: of the 286 patients, 14 patients did not start treatment. of the remaining patients, 25 (9%) dropped out of therapy. The 2 groups were comparable regarding baseline characteristic. After treatment, significant improvements were observed with regard to pain, disability, and most of the quality of life dimensions. These effects were sustained over the 24-month follow-up period. There were some statistically significant differences between the 2 groups relating to secondary end points, Roland-Morris disability questionnaire, and in the MOS 36-Item Short-Form Health Survey the "physical functioning" dimension and the "physical component Summary." Conclusion: Both groups showed long-term improvements in pain and disability scores, with only minor statistically significant differences between the 2 groups. The minor outcome difference in favor of the group-based multidisciplinary rehabilitation program is hardly of clinical interest for individual patients.

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DO - 10.1097/BRS.0b013e3181b8db2e

M3 - Journal article

VL - 35

SP - 469

EP - 476

JO - Spine Rehabilitation

JF - Spine Rehabilitation

IS - 5

ER -