Objectives: Multimodal cognitive behavior programs are found to be appropriate treatment for patients with chronic widespread pain [CWP]. The aim of this study was to investigate whether follow-up body awareness group training could cause a greater long-lasting effect and promote more patients to return to work.Methods: In a randomized controlled trial, 52 patients with CWP and more than 10 tender points were enrolled after having participated in a multimodal program. The intervention group attended a psychomotor physiotherapy group training 18 times during 1.5 years. The training started one month after the end of multimodal treatment. The control group received treatment as usual. Outcome measures were work status, Global Physiotherapeutic Examination, pain levels, and quality of life. All patients were tested within two weeks after the multimodal treatment, after 12 months, and after 18 months.Results: Improvement in test scores was demonstrated in both groups over time. However, the intervention group demonstrated fewer tender points and a reduced distribution of pain. After one year, two-thirds of the intervention group and one-third of the control group was back at work, while after 1.5 years the difference between groups was less and not statistically significant.Conclusions: Improvement over time was obtained for all patients who had participated in the multimodal program. Indication was provided that follow-up psychomotor physiotherapy based on body awareness training might cause additional improvement of symptoms and a higher rate of return to work.

Responsiveness varied among the 10 physical tests.

The Comprehensive Core Set for LBP to a large degree contains daily life and work-related activities frequently reported as difficult to perform by patients with long-lasting LBP. The categories, however, are very broad and do not provide specified descriptions of the most frequently reported activity limitations such as sitting, standing and walking. The Brief Core Set does not include categories for frequently reported activities such as pulling/pushing and leisure/recreation activities. ICF Core Sets for LBP seem suitable for obtaining a gross overview of the patients' functional limitations, but do not give sufficient information from a therapeutic point of view.

Most measures demonstrated change that was of significance to the patients after rehabilitation. Change in spinal mobility and back strength assessed by physical tests contributed to explain the patients' impression of change after controlling for change in pain and daily life functioning and may seem important to assess in addition to the self-report measures in intervention studies.