The Efficacy of a Short Education Program and a Short Physiotherapy Program for Treating Low Back Pain in Primary Care

Albaladejo, Celia; Kovacs, Francisco M.; Royuela, Ana; Pino, Rafaël del; Zamora, Javier

doi:10.1097/brs.0b013e3181b9c9a7

Cited by 103 publications

(99 citation statements)

References 58 publications

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“…Results from RCT on their effectiveness in LBP are mixed (3,8,11,35,(40)(41)(42)(43)(44) and these prior studies have included patients with existing LB symptoms, either acute or chronic LBP. We are not aware of comparable RCT about LB-specific self-care information for non-sick-listed employees in an OH setting.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial

Rantonen¹,

Vehtari²,

Karppinen³

et al. 2013

Scand J Work Environ Health

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Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial by Rantonen J, Vehtari A, Karppinen J, Luoto S, Viikari-Juntura E, Hupli M, Malmivaara A, Taimela S Respondents with mild LB symptoms were randomized into the Back Book (control) Back Book+Advice (intervention) groups. Both occupational health (OH) interventions were effective, but supplementary oral information was not more effective compared to the booklet alone. Policy implications: Patient advice is important in the OH setting, but we need more evidence of the effectiveness of various types of information. Original article Scand J Work Environ Health. 2014;40(2):156-166. doi:10.5271/sjweh.3398 Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial by Jarmo Rantonen, MD, 1 Aki Vehtari, DrTech, 2 Jaro Karppinen, MD, PhD,1, 4 Satu Luoto, MD, PhD, MD, PhD, 1 Markku Hupli, MD, PhD, 3 Antti Malmivaara, MD, PhD, 5 Simo Taimela, MD, PhD 6,7 Rantonen J, Vehtari A, Karppinen J, Luoto S, Viikari-Juntura E, Hupli M, Malmivaara A, Taimela S. Face-to-face information combined with a booklet versus a booklet alone for treating mild low-back pain: a randomized controlled trial. Scand J Work Environ Health. 2014;40(2):156-166, doi:10.5271/sjweh.3398 AffiliationObjective The aim of this study was to determine the effectiveness of face-to-face information for the treatment of mild low-back pain (LBP) in an occupational health (OH) setting. MethodsWe conducted a 48-month randomized controlled trial (RCT) with two 1:1 allocated parallel groups of forestry company employees. Eligibility criteria included permanent employment, age <57 years, and mild LBP [visual analogue scale (VAS) 10-34 mm] in a survey. The intervention group received the Back Book, an information booklet on how to manage LBP, with an additional face-to-face review of the booklet by an OH nurse. The control group received the booklet only. Primary outcomes were physical impairment (Roland-Morris 18-item (RM-18) Disability Questionnaire), LBP (VAS 100 mm), health-related quality of life [15-dimensional quality of life (15-D)] during two years and sickness absence (SA) up to four years. Participants were assigned using block randomization with a computer-generated scheme. ResultsThe RCT comprised 181 participants (72% male, mean age 44 years). There were no differences between the treatment arms in any of the primary outcomes at any time point. At 24 months, the mean group differences (intervention versus control) were: RM-18: 0 [95% confidence interval (95% CI) -1-1], VAS: 3 mm (95% CI -3-8), and 15-D 0.00 (95% CI -0.02-0.02). The difference in cumulative sickness absence days at 48 months were -3 (95% CI -28-21) for total and 1 (95% CI -3-5) for LBP specific sick leaves. Exploratory analysis revealed no differences at subgroup-levels either.Conclusions Face-to-face patient information by an OH nurse in addition to a booklet was not more eff...

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Section: Comparison With Previous Studiesmentioning

confidence: 99%

Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial

Rantonen¹,

Vehtari²,

Karppinen³

et al. 2013

Scand J Work Environ Health

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“…This educational treatment is actually recommended [4] and demonstrated, even when patients only receive this education, efficacy on pain and function similar to what was seen with exercises [23] in a randomised, controlled trial. The combination of education and rehabilitative treatment demonstrated an improvement in symptoms that surpassed that of education alone and far surpassed no treatment at all [20]. This educational approach is the one most requested by patients [24].…”

Section: Discussionmentioning

confidence: 98%

“…Our programme is different from those that already exist since we mainly focus management on education and behaviour modification. We combine short-term treatment in the form of one single week of hospitalisation, unlike other programmes [19,20] with more mediumterm treatment since patients are seen again after six months (in most other studies follow-up was more like three months later).…”

Section: Discussionmentioning

confidence: 99%

Assessing the Benefit of an Educational Program in a Rehabilitation Program over a Week in 99 Patients with Chronic Low Back Pain

Trouvin¹,

Francois²

2016

J Nov Physiother

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Objectives: Some patients with chronic low back pain are not eligible to intensive rehabilitation program because of the intensity of their pain. We assessed the value of an educational program in a rehabilitation program over a week in chronic low back pain. Methods:Patients aged 18 to 75 years with chronic low back pain were included. The rehabilitation program took place during a five-day hospitalisation in the rheumatology department of the Rouen University Hospital involving patients receiving multidisciplinary management with collective and individual workshops with special focus on education along with structured rehabilitation exercises. On the fifth day, patients and caregivers established goals to achieve within the six-month period. Patients had a follow-up visit six months later. The objective was to evaluate whether or not the goals were achieved at 6 months later.Results: Ninety-nine patients were included, and 78 were re-evaluated after six months. The patients achieved 74% of the goals that they had established, with significant behavioural changes. Clinically and functionally: significant decrease in pain VAS during the program, significant decrease in the fingertip-to-floor distance during the program and at the 6 months follow-up, significant improvement in the functional questionnaire. Conclusion:With to the educational part of their program, the patients achieved a mean of 74% of the goals. Moreover, the training course improved pain and function. For patients with a high level of pain and/or disability our short program with multidisciplinary management and an educational approach seems to be interesting as a first step before a more intensive rehabilitation.Keywords: Chronic low back pain; Therapeutic education; Multidisciplinary management; Rehabilitation Key Points1. Some of the chronic low back pain patients rapidly develop a high level of chronic pain and disability and therefore are not eligible for back school and intensive back pain rehabilitation; for these severe patients, based on the European recommendations and the biopsychosocial model, we created a "low back pain" training session with a special reinforcement on therapeutic education. 2.The training session is a one week multidisciplinary management, with multiple individual and group workshops on the various aspects of the chronic low back pain and its consequences in the different aspects of life.3. We asked patients to set goals to achieve by the sixth month following the training course in order to give them a starting point for following their efforts once they completed the week of training, the patients achieved a mean of 75% of the goals they had set individually.4. After the week training session, the pain scale significantly decrease as well as the finger-to-floor distance, the modified Schober's test and the functional questionnaire (Roland Morris Disability Questionnaire and Dallas Pain Questionnaire)

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“…E, apesar de achados de uma revisão recente apontarem que a evidência de eficácia de autocuidado para DL não é clara, apresentando evidência de qualidade moderada com pequenos efeitos sobre dor e incapacidade (Oliveira et al, 2012), os resultados do presente estudo e de outras pesquisas (Heymans et al, 2004) observaram diminuição da dor local/referida e da incapacidade. Outros estudos indicam redução de outras variáveis como o medo, a ansiedade/depressão, as reincidências e atitudes catastróficas, além do incremento da atividade física, do aumento da qualidade de vida (Albaladejo et al, 2010;Damush et al, 2003;Meng et al, 2011;Udermann et al, 2004).…”

Section: Tabelaunclassified

“…Dentre os estudos que investigaram efeitos associados de programas educacionais e de autocuidado relacionados à DL aguda e cróni-ca, resultados significativos foram demonstrados no que se refere ao controle da dor e da incapacidade, incremento da atividade física, diminuição do medo, redução da ansiedade/depressão, aumento da qualidade de vida e diminuição de reincidências e frequência dos sintomas (Albaladejo, Kovacs, Royuela, del Pino, & Zamora, 2010;Damush et al, 2003;Heymans, van Tulder, Esmail, Bombardier, & Koes, 2004;Meng et al, 2011;Udermann et al, 2004). Porém, poucos autores investigaram seus efeitos na DL crônica da população idosa (Haas et al, 2005;Kovacs et al, 2007), encontrando resultados positivos e significativos apenas na incapacidade funcional relacionada à Programa educacional de autocuidado de coluna | 55 DL dentre as várias variáveis estudadas como: intensidade de dor, saúde geral, qualidade de vida, entre outras.…”

Section: Introductionunclassified

Efeitos de um programa educacional de autocuidado de coluna em idosos com dor lombar crônica: um estudo quasi-experimental

Rios

Leite

Pereira³

et al. 2015

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ARTIGO ORIGINAL | ORIGINAL ARTICLE RESUMOO estudo teve por objetivo verificar os efeitos de um programa educacional de autocuidado de coluna, no controle da dor e na incapacidade em idosos ativos com dor lombar crônica (DL) não específica. Os idosos foram divididos em grupo experimental (GE n = 17) e controle (GC n = 13). A intervenção consistiu na entrega de uma cartilha educativa e um workshop. Foram variáveis dependentes: 1. intensidade da dor (EVN), 2. capacidade funcional relacionada à DL (RMQ), 3. quantidade de pontos de dor, 4. uso de medicação para DL e 5. frequência de uso de medicação para DL. Houve avaliação pré e após 1 mês da primeira avaliação. Na avaliação intragrupo foi observada no GE diminuição significativa de todos os parâmetros avaliados (todos p < 0,05) fato não observado no GC. Quanto à análise entre os grupos houve melhora significativa com tamanhos de efeitos moderados a grandes no GE para EVN (p=0.003, TE=0.53), no RMQ (p=0.037, TE=0.38) e nos pontos de dor (p=0.006, TE=0.49). Os resultados demonstraram que a cartilha pode ser uma ferramenta útil, capaz de gerar independência no cuidado e tratamento da DL crônica em idosos ativos.Palavras-chave: Lombalgia, idoso, autocuidado, educação ABSTRACT The purpose of this paper was to investigate the effects of an educational self-care program of spine in the control of pain and disability in actives older adults with chronic non-specific low back pain (LBP). They were divided in an experimental group (EG n = 17) and a control group (CG n = 13). The intervention consisted of delivering an educational booklet and also attending a workshop. Dependent variables were: 1. pain intensity (EVN), 2. functional capacity related to LBP (RMQ), 3. amount of pain points, 4. medication for LBP, 5. frequency of medication for LBP. There was evaluation pre and after 1 month of the first evaluation. The intragroup evaluation was observed in EG significant reduction of all parameters (all p < 0.05) was not observed in CG. Regarding the analysis between groups showed significant improvement with moderate to large effect sizes in EG to EVN (p=0.003, TE=0.53), RMQ (p=0.037, TE=0.38) and pain points (p=0.006, TE=0.49). The results highlight the booklet as a useful tool, capable of generating independence in the self-care for active older adults with chronic LBP.

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The Efficacy of a Short Education Program and a Short Physiotherapy Program for Treating Low Back Pain in Primary Care

Cited by 103 publications

References 58 publications

Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial

Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial

Assessing the Benefit of an Educational Program in a Rehabilitation Program over a Week in 99 Patients with Chronic Low Back Pain

Efeitos de um programa educacional de autocuidado de coluna em idosos com dor lombar crônica: um estudo quasi-experimental

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