Evaluation of a multi-disciplinary back pain rehabilitation programme--individual and group perspectives.
OBJECTIVE
To evaluate the impact of a multi-disciplinary back pain rehabilitation programme using a combination of individual and group change data.


METHODS
A total of 261 consecutive patients attending an assessment session for the back pain rehabilitation programme completed the SF-36 health survey questionnaire. The patients were requested to complete the questionnaires again at programme completion and at the 6-month follow-up. The Reliable Change Index was used to define 'clinical significance' in terms of the assessment of individual change.


RESULTS
Half of those patients considered to be suitable for the programme subsequently completed it. In group terms, non-completers scored lower than completers on all SF-36 scales. Statistically significant improvements were evident for those completing the programme (all scales at P < 0.000), with improvement maintained at follow-up. In individual terms, 'clinical significance' was exceeded most frequently in the Physical Functioning and Role Physical scales. Whilst some participants lost previous improvements between completion and follow-up, others improved over this same time period. The majority of those completing the programme showed improvement in at least one scale.


CONCLUSIONS
Adding assessment of individual change to traditional group change measures provides greater insight into the impact a rehabilitation programme has upon participants' quality of life. Whilst the programme is clearly effective for those who complete it, work is required to limit post-programme deterioration and improve uptake.
Baird
Andrew
A
Centre for Psychological Research, University of Derby, Kedlestone Road, Derby DE22 1GB, UK. A.Baird@derby.ac.uk
Worral
Lisa
L
Haslam
Cheryl
C
Haslam
Roger
R
D000328:Adult; D001416:Back Pain / Q000534:rehabilitation*; D003625:Data Collection; D005260:Female; D006126:Group Processes; D006304:Health Status; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D010348:Patient Care Team; D015397:Program Evaluation; D011581:Psychological Tests; D012047:Rehabilitation Centers; D011795:Surveys and Questionnaires