title: Evaluation of a rolling rehabilitation programme for patients with non-specific low back pain in primary care: an observational cohort study.
abstract: OBJECTIVE
  The Back Rehabilitation Programme (BRP) is a group exercise programme for patients with non-specific low back pain (NSLBP) that combines cognitive behavioural therapy principles and therapeutic exercise to empower patients to self-manage their condition. Poor attendance and high attrition rates resulted in changes to the format of the programme from a standard sequential approach to a continual rolling approach. The aim of this study was to evaluate the effectiveness of this new approach on patient outcomes and its impact on attendance rates.
  
  
  METHODS
  A service evaluation, using a retrospective, observational cohort design, of all patients with NSLBP who attended the BRP during a 12-month period was undertaken. Outcome measures used were as follows: Bournemouth Questionnaire (BQ); fitness tests: sit to stand test, step test and walk test (taken at baseline and post programme); and attendance (taken post programme).
  
  
  RESULTS
  Of the patients, 56% had an improved BQ score ≥ 47%, indicating a clinically significant change. Inferential testing showed statistically significant improvements in the BQ and all three fitness tests post programme (P< 0.0001). In total, 62 patients attended the rolling BRP, and 41 patients (66%) completed. Thus, the percentage of patients completing the new programme had doubled compared with the original standard programme.
  
  
  CONCLUSIONS
  Patients with NSLBP who attended the continual rolling BRP show clinical and statistical improvements. The rolling format also appeared to enhance patient attendance. As such, the rolling BRP should be considered by practitioners as an effective management strategy when treating patients with NSLBP.
authors.affiliation: Musculoskeletal Clinical Assessment and Treatment Service, Bridgewater Community Healthcare NHS Foundation Trust, Lancashire, UK.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Arden
authors.affiliation: Manchester Metropolitan University, Manchester, UK.
authors.forename: Francis
authors.initials: F
authors.lastname: Fatoye
authors.affiliation: Manchester Metropolitan University, Manchester, UK.
authors.forename: Gillian
authors.initials: G
authors.lastname: Yeowell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D011320:Primary Health Care; D011788:Quality of Life; D012189:Retrospective Studies; D012648:Self Care
keywords: evaluation; health care; health services research