title: Pain and functional outcomes after outpatient physiotherapy in patients with low back pain.
abstract: BACKGROUND
  Physiotherapy treatment programs are recommended in the rehabilitation of low back pain (LBP). Rehabilitation institutions are increasingly asked to demonstrate the outcomes of their intensive physiotherapy services.
  
  
  OBJECTIVE
  To describe pain and functional outcome measures following a 6-month outpatient physiotherapy treatment program in patients with LBP.
  
  
  METHODS
  A total of 85 patients were analysed after being treated with a combination of physiotherapeutic treatment modalities 2-3 days weekly. Pain and disability were measured before, 3 and 6 months after the onset of treatment. Isometric trunk muscle strength for flexion and extension and flexibility of dorsal trunk and thigh structures were measured before and 6 months after treatment.
  
  
  RESULTS
  After 6 months, pain at rest decreased from a median of 4.0 to 0.0 (p < 0.01) and pain during activity from a median of 5.5 to 2.0 on the numeric rating scale (p < 0.001). The Roland-Morris Disability (RMDQ) score decreased from a median of 7.0 to 3.0 (p < 0.001). Mean trunk muscle flexion strength increased from 133.7 to 156.0 Nm and for extension from 235.5 to 278.3 Nm (p < 0.001). Flexibility was improved from a mean of -5.9 to -1.4 cm (p < 0.001). A moderate correlation between pain at rest and RMDQ score was found after 3 (r = 0.532, p < 0.01) and 6 months (r = 0.508, p < 0.01).
  
  
  CONCLUSIONS
  Patients with LBP who were treated with the physiotherapeutic treatment program showed a clinically relevant reduction of pain and disability with improved trunk muscle strength and flexibility. Reductions in pain and disability do not seem to correlate with increased trunk muscle strength and flexibility. No conclusions can be declared about long-term changes after the intervention.
authors.affiliation: Faculty of Health Care (Therapeutic Sciences), Niederrhein University of Applied Sciences, Reinarzstr. 49, 47805, Krefeld, Germany. martin.alfuth@hs-niederrhein.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Alfuth
authors.affiliation: medicoreha Welsink Rehabilitation GmbH, Ambulante Fachkliniken für Rehabilitation, Preußenstr. 84a, 41464, Neuss, Germany.
authors.forename: Dieter W
authors.initials: DW
authors.lastname: Welsink
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010043:Outcome and Process Assessment, Health Care; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular
keywords: Disability; Evidence-based practice; Physiotherapeutic treatment program; Treatment outcome; Trunk muscle strength