Efficiency of three treatment strategies on occupational and quality of life impairments for chronic low back pain patients: is the multidisciplinary approach the key feature to success?
Clin Rehabil
; 31(10): 1364-1373, 2017 Oct.
Article
in En
| MEDLINE
| ID: mdl-28592147
ABSTRACT
OBJECTIVE:
To compare the effectiveness of three treatment strategies for chronic low back pain with varying biomechanical intensity and multidisciplinary approach.METHODS:
A monocentric randomized controlled trial with a 12-months follow-up, conducted in the French Valley Loire region from May 2009 to April 2013. Participants were working-aged patients with chronic low back pain referred to a French chronic low back pain care-network to support medical and occupational issues. Three treatment strategies, each for five weeks were compared (i) intensive and multidisciplinary program conducted in a rehabilitation center; (ii) less intensive outpatient program conducted by a trained private physiotherapist; (iii) mixed strategy combining the same outpatient program associated with a weekly multidisciplinary intervention. The effects of treatment conditions were compared using an "intention to treat"approach:
Number of days' sick leave during the 12-months following treatment, and quality of life and social ability assessed by auto-questionnaires.RESULTS:
A total of 159 patients (58.9% men, 41.5 ± 10.3 years old, median duration of sick leave = 221.0 days (127.5-319.0)) were included. Sick leave duration significantly decreased during the 12-months following treatment in the three groups. There was no significant difference for the evolution of participants' quality of life, social ability, and personal beliefs between the three groups.CONCLUSION:
This study confirms that disparate treatments might show similar effectiveness because they could all work through concomitant changes in beliefs, attitudes, and coping mechanisms. The original mixed strategy can treat a larger number of chronic low back pain patients, at a lower cost and provide local community-based care. CLINICAL TRIAL REGISTRATION NCT02030171.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patient Care Team
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Low Back Pain
/
Exercise Therapy
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Chronic Pain
Type of study:
Clinical_trials
Limits:
Adult
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Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
Clin Rehabil
Journal subject:
REABILITACAO
Year:
2017
Type:
Article
Affiliation country:
France