title: Long-term effects of interprofessional biopsychosocial rehabilitation for adults with chronic non-specific low back pain: a multicentre, quasi-experimental study.
abstract: BACKGROUND
  Improvement of the long-term effectiveness of multidisciplinary ortho-paedic rehabilitation (MOR) in the management of chronic non-specific low back pain (CLBP) remains a central issue for health care in Germany. We developed an interprofessional and interdisciplinary, biopsychosocial rehabilitation concept named "PASTOR" to promote self-management in adults with CLBP and compared its effectiveness with the current model of MOR.
  
  
  METHODS
  A multicentre quasi-experimental study with three measurement time points was implemented. 680 adults aged 18 to 65 with CLBP were assed for eligibil-ity in three inpatient rehabilitation centres in Germany. At first the effects of the MOR, with a total extent of 48 hours (control group), were assessed. Thereafter, PASTOR was implemented and evaluated in the same centres (intervention group). It consisted of six interprofessional modules, which were provided on 12 days in fixed groups, with a total extent of 48 hours. Participants were assessed with self-report measures at baseline, discharge, and 12 months for functional ability (primary outcome) using the Hannover Functional Ability Questionnaire (FFbH-R) and vari-ous secondary outcomes (e.g. pain, health status, physical activity, pain coping, pain-related cognitions).
  
  
  RESULTS
  In total 536 participants were consecutively assigned to PASTOR (n=266) or MOR (n=270). At 12 months, complete data of 368 participants was available. The adjusted between-group difference in the FFbH-R at 12 months was 6.58 (95% CI 3.38 to 9.78) using complete data and 3.56 (95% CI 0.45 to 6.67) using available da-ta, corresponding to significant small-to-medium effect sizes of d=0.42 (p<0.001) and d=0.10 (p=0.025) in favour of PASTOR. Further improvements in secondary out-comes were also observed in favour of PASTOR.
  
  
  CONCLUSIONS
  The interprofessional and interdisciplinary, biopsychosocial rehabilita-tion program PASTOR shows some improvements of the long-term effectiveness of inpatient rehabilitation in the management of adults with CLBP. Further insights into mechanisms of action of complex intervention programs are required.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02056951.
authors.affiliation: Friedrich-Alexander-University Erlangen-Nürnberg, Institute of Sport Science and Sport, Erlangen, Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Semrau
authors.affiliation: Friedrich-Alexander-University Erlangen-Nürnberg, Institute of Sport Science and Sport, Erlangen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Hentschke
authors.affiliation: University of Würzburg, Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences, Würzburg, Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Buchmann
authors.affiliation: University of Würzburg, Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences, Würzburg, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Meng
authors.affiliation: University of Würzburg, Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences, Würzburg, Germany.
authors.forename: Heiner
authors.initials: H
authors.lastname: Vogel
authors.affiliation: University of Würzburg, Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences, Würzburg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Faller
authors.affiliation: Reha-Zentrum am Sankt Josef-Stift, Sendenhorst, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Bork
authors.affiliation: Friedrich-Alexander-University Erlangen-Nürnberg, Institute of Sport Science and Sport, Erlangen, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Pfeifer
mesh_terms: D002908:Chronic Disease / Q000523:psychology / Q000628:therapy; D003071:Cognition; D005260:Female; D006801:Humans; D059012:Lost to Follow-Up; D017116:Low Back Pain / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011788:Quality of Life; D016896:Treatment Outcome