Differences in outcome of a multidisciplinary treatment between subgroups of chronic low back pain patients defined using two multiaxial assessment instruments: the multidimensional pain inventory and lumbar dynamometry.
OBJECTIVE
To investigate the effects of a multidisciplinary back school programme (Roessingh Back Rehabilitation Programme, RRP) compared with usual care, as well as differences in treatment outcome between subgroups defined using two multiaxial assessment instruments: the Multidimensional Pain Inventory (MPI-DLV) and lumbar dynamometry.


METHODS
Randomized controlled trial.


METHODS
Rehabilitation.


METHODS
One hundred and sixty-three patients with chronic, aspecific low back pain.


METHODS
All subjects were randomly assigned either to a multidisciplinary, physically oriented group treatment or to their usual care.


METHODS
The Roland Disability Questionnaire and health-related quality of life (EuroQol, EQ5-D) were measured as primary outcomes before randomization and after eight weeks and six months follow-up.


RESULTS
Only 30-50% of the patients in the RRP group showed improvement and this number is not significantly different from the control group. Subgroup analyses give some first indications that multiaxial measurement instruments can be used to identify subgroups with differences in treatment effects.


CONCLUSIONS
The overall effect of a multidisciplinary treatment is disappointing, however multiaxial assessment before admission might be valuable in clinical practice, resulting in more effective treatments for patients with chronic low back pain.
Vollenbroek-Hutten
Miriam M R
MM
Roessingh Research and Development, Roessinghsbleekweg 33b, 7752 AH Enschede, The Netherlands. m.vollenbroek@rrd.nl
Hermens
Hermie J
HJ
Wever
Danël
D
Gorter
Michiel
M
Rinket
Joost
J
Ijzerman
Maarten J
MJ
D000328:Adult; D002908:Chronic Disease; D004185:Disability Evaluation; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D009426:Netherlands; D009788:Occupational Therapy; D010043:Outcome and Process Assessment, Health Care; D010147:Pain Measurement; D010348:Patient Care Team; D026741:Physical Therapy Modalities; D015397:Program Evaluation; D011788:Quality of Life; D016037:Single-Blind Method