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Medicine (Baltimore) ; 98(1): e13825, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30608395

RESUMO

Treatment modalities of spinal pain patients are discussed diversely, and different multimodal therapy programs have been developed. Purpose of the present study was to evaluate therapy outcome and effectiveness of an inpatient interdisciplinary and multimodal treatment program.This prospective multicentre clinical trial has been performed with patients from orthopedic hospitals receiving a functional musculoskeletal therapy pathway. Outcome measures were pain intensity and back-specific function (Oswestry Disability Index) before (T1) and after the intervention (T2) as well as after 6 and 12 months (T3, T4). Statistical approach included parametric (t test) and nonparametric (Wilcoxon-test) tests and the calculation of effect sizes. Additionally, a statistical subgroup analysis based on selected parameters (degree of pain chronicity, gender, and age) was performed using linear mixed models.In total, 249 patients (42.6% men, 57.4% women) with spinal pain were included, 133 patients were accessible for follow-up at T3 and 106 patients at T4.Average pain (AP) reduced significantly (P <.001) from T1 to T4 with an effect size of 0.99. Back-specific function also improved (P <.001) over all measuring time points (TP) (effect size: 0.63). Furthermore, the statistical subgroup analysis demonstrated the efficacy of the treatment concept within the subgroup parameters chronicity degree and age.A functional musculoskeletal therapy pathway including treatment of musculoskeletal dysfunctions appears to be beneficial in terms of treating pain and function. Pain chronicity and age seems to be factors influencing therapy outcome. Further studies are needed to examine the superiority of these inpatient programs for back pain including control groups.


Assuntos
Dor nas Costas/terapia , Dor Crônica/terapia , Procedimentos Ortopédicos/métodos , Adulto , Idoso , Dor nas Costas/fisiopatologia , Dor Crônica/fisiopatologia , Terapia Combinada , Avaliação da Deficiência , Feminino , Seguimentos , Alemanha , Humanos , Pacientes Internados , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Coluna Vertebral/fisiopatologia , Resultado do Tratamento , Adulto Jovem
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