OBJECTIVE: The objective of this study was to examine whether a multimodal, secondary prevention program (MP) is superior to a general physical exercise program (EP) in influencing the process leading to chronic low back pain (LBP) in nurses with a history of back pain. DESIGN: The study was conducted as a randomized controlled parallel-group trial. SETTING: The interventions were performed in a single center at the Department of Physical and Rehabilitation Medicine at the University of Munich in Germany. PARTICIPANTS: A total of 235 nurses from 14 nearby hospitals and nursing homes who experienced at least one episode of back pain during the previous 2 years were invited into the study. Of these, 183 nurses were enrolled and 169 (83 in the MP and 86 in the EP) qualified for the intent-to-treat analysis. INTERVENTIONS: The EP consisted of 11 group sessions, each lasting 1 hour. After introductory sessions, subsequent sessions included general physical strengthening and stretching exercises as well as instructions for a home-training program. The MP consisted of 17 group sessions of 1.75 hours and one individual session of 45 minutes. In addition to the full EP, the MP included 5 psychological units, 7 segmental stabilization exercises units, and 8 ergonomic and workplace-specific units. MAIN OUTCOME MEASUREMENTS: The primary study end-point variable was pain interference, and the secondary study end-point variables were pain intensity and functioning as measured with the West Haven-Yale Multidimensional Pain Inventory and the Short Form-36, respectively. These study end-point variables were defined a priori. RESULTS: There was no statistically significant difference between the 2 groups. Small-to-moderate effects were observed in both intervention programs across all study end-point variables. For pain interference, the effect size at 12 months after intervention was 0.58 in the MP and 0.47 in the EP. CONCLUSIONS: A multimodal program is not superior to a general exercise program in influencing the process leading to chronic LBP in a population of nurses with a history of pain. The most likely explanation is a common psychological mechanism leading to improved pain interference that is irrespective of the program used. Considering the lower resources of the general exercise program, the expense for a multimodal program is not justified for the secondary prevention of LBP and disability.
RCT Entities:
OBJECTIVE: The objective of this study was to examine whether a multimodal, secondary prevention program (MP) is superior to a general physical exercise program (EP) in influencing the process leading to chronic low back pain (LBP) in nurses with a history of back pain. DESIGN: The study was conducted as a randomized controlled parallel-group trial. SETTING: The interventions were performed in a single center at the Department of Physical and Rehabilitation Medicine at the University of Munich in Germany. PARTICIPANTS: A total of 235 nurses from 14 nearby hospitals and nursing homes who experienced at least one episode of back pain during the previous 2 years were invited into the study. Of these, 183 nurses were enrolled and 169 (83 in the MP and 86 in the EP) qualified for the intent-to-treat analysis. INTERVENTIONS: The EP consisted of 11 group sessions, each lasting 1 hour. After introductory sessions, subsequent sessions included general physical strengthening and stretching exercises as well as instructions for a home-training program. The MP consisted of 17 group sessions of 1.75 hours and one individual session of 45 minutes. In addition to the full EP, the MP included 5 psychological units, 7 segmental stabilization exercises units, and 8 ergonomic and workplace-specific units. MAIN OUTCOME MEASUREMENTS: The primary study end-point variable was pain interference, and the secondary study end-point variables were pain intensity and functioning as measured with the West Haven-Yale Multidimensional Pain Inventory and the Short Form-36, respectively. These study end-point variables were defined a priori. RESULTS: There was no statistically significant difference between the 2 groups. Small-to-moderate effects were observed in both intervention programs across all study end-point variables. For pain interference, the effect size at 12 months after intervention was 0.58 in the MP and 0.47 in the EP. CONCLUSIONS: A multimodal program is not superior to a general exercise program in influencing the process leading to chronic LBP in a population of nurses with a history of pain. The most likely explanation is a common psychological mechanism leading to improved pain interference that is irrespective of the program used. Considering the lower resources of the general exercise program, the expense for a multimodal program is not justified for the secondary prevention of LBP and disability.
Authors: Luciana G Macedo; Bruno T Saragiotto; Tiê P Yamato; Leonardo O P Costa; Luciola C Menezes Costa; Raymond W J G Ostelo; Christopher G Maher Journal: Cochrane Database Syst Rev Date: 2016-02-10
Authors: Gabriel Ching Ngai Leung; Prudence Wing Hang Cheung; Gareth Lau; Sin Ting Lau; Keith Dip Kei Luk; Yat Wa Wong; Kenneth Man Chee Cheung; Paul Aarne Koljonen; Jason Pui Yin Cheung Journal: BMC Musculoskelet Disord Date: 2021-03-06 Impact factor: 2.362
Authors: Fabrizio Russo; Giuseppe Francesco Papalia; Gianluca Vadalà; Luca Fontana; Sergio Iavicoli; Rocco Papalia; Vincenzo Denaro Journal: Int J Environ Res Public Health Date: 2021-11-30 Impact factor: 3.390
Authors: Bruno T Saragiotto; Christopher G Maher; Tiê P Yamato; Leonardo O P Costa; Luciola C Menezes Costa; Raymond W J G Ostelo; Luciana G Macedo Journal: Cochrane Database Syst Rev Date: 2016-01-08