title: A 10-year follow-up of tailored behavioural treatment and exercise-based physiotherapy for persistent musculoskeletal pain.
abstract: OBJECTIVE
  To study the long-term outcomes of two interventions targeting patients with sub-acute and persistent pain in a primary care physiotherapy setting.
  
  
  METHODS
  A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants.
  
  
  METHODS
  Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition).
  
  
  METHODS
  Pain-related disability was the primary outcome. The maximum pain intensity, pain control, fear of movement, sickness-related absence (register data) and perceived benefit and confidence in coping with future pain problems were the secondary outcomes.
  
  
  RESULTS
  Forty-three (44%) participants responded to the follow-up survey, 20 in the tailored behavioural medicine treatment group and 23 in the exercise-based physiotherapy group. The groups did not differ in terms of the change in the scores for the primary outcome ( p=0.17) of pain-related disability between the experimental group (median: 2.5, Q1-Q3: -2.5-14.25), and the control group (median: 0, Q1-Q3: -5-6). Further, there were also no significant differences found for the secondary outcomes except for sickness-related absence, where the exercise-based physiotherapy group had more days of sickness-related absence three months before treatment ( p= 0.02), and at the 10-year follow-up ( p=0.03).
  
  
  CONCLUSIONS
  The beneficial effects favouring tailored behavioural medicine treatment that observed post-treatment and at the two-year follow-up were not maintained 10 years after treatment.
authors.affiliation: 1 Department of Neuroscience, Uppsala University, Uppsala, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Emilson
authors.affiliation: 1 Department of Neuroscience, Uppsala University, Uppsala, Sweden.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Demmelmaier
authors.affiliation: 2 Research and Development Center Spenshult, Halmstad, Sweden. Department of Public Health, and Community medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Bergman
authors.affiliation: 3 Department of Psychology, Uppsala University, Uppsala, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Lindberg
authors.affiliation: 4 School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Denison
authors.affiliation: 1 Department of Neuroscience, Uppsala University, Uppsala, Sweden.
authors.forename: Pernilla
authors.initials: P
authors.lastname: Åsenlöf
mesh_terms: D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000175:diagnosis* / Q000534:rehabilitation*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
keywords: Chronic pain; behavioural medicine; long-term compliance; physical exercise; primary care