Multidisciplinary group rehabilitation versus individual physiotherapy for chronic nonspecific low back pain: a randomized trial.
METHODS
A randomized trial.


OBJECTIVE
To evaluate the effectiveness of a semi-intensive multidisciplinary rehabilitation for patients with chronic low back pain in an outpatient setting.


BACKGROUND
Systematic reviews have shown that there is strong evidence that intensive multidisciplinary treatment (>100 hours), which includes functional restoration, improves function among chronic patients with low back pain, and moderate evidence that it reduces pain but contradictory evidence regarding improvement of working ability. However, there is paucity of data whether semi-intensive outpatient multidisciplinary rehabilitation in groups is more effective than individual physiotherapy.


METHODS
A total of 120 women employed as healthcare and social care professionals with nonspecific chronic low back pain were recruited from two occupational healthcare centers. The patients were randomized into two intervention programs. Multidisciplinary rehabilitation (n = 59) was conducted in groups and comprised of physical training, workplace interventions, back school, relaxation training, and cognitive-behavioral stress management methods for 70 hours. The individual physiotherapy (n = 61) included physical exercise and passive treatment methods administered for 10 hours. Main outcome measures were: back pain and sciatic pain intensity, disability, sick leaves, healthcare consumption, symptoms of depression, and beliefs of working ability after 2 years.


RESULTS
There were no statistically significant differences between the two treatment groups in main outcome measures just after rehabilitation, at 6-, at 12-, or 24-month follow-up. In both intervention arms, however, the before-and-after comparison showed favorable effects, and the effects were still maintained at 2 years follow-up.


CONCLUSIONS
The results of this study indicate that semilight outpatient multidisciplinary rehabilitation program for female chronic low back pain patients does not offer incremental benefits when compared with rehabilitation carried out by a physiotherapist having a cognitive-behavioral way of administering the treatment.
Kääpä
Eeva Helena
EH
Department of Surgery, Physical Medicine and Rehabilitation, Hus, Finland. eeva.kaapa@hus.fi
Frantsi
Kirsi
K
Sarna
Seppo
S
Malmivaara
Antti
A
D000328:Adult; D003131:Combined Modality Therapy; D003154:Community Medicine; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011788:Quality of Life; D016896:Treatment Outcome