Yoann Ronzi1, Ghislaine Roche-Leboucher1, Cyril Bègue2, Valerie Dubus1, Luc Bontoux1, Yves Roquelaure3,4, Isabelle Richard1,4, Audrey Petit3,4. 1. 1 Department of Physical Medicine and Rehabilitation, University Hospital of Angers, Angers, France. 2. 2 Department of General Practice, University of Angers, Angers, France. 3. 3 Occupational Health Department, University Hospital of Angers, Angers, France. 4. 4 LUNAM University, University of Angers, Angers, France.
Abstract
OBJECTIVE: To compare the effectiveness of three treatment strategies for chronic low back pain with varying biomechanical intensity and multidisciplinary approach. METHODS: A monocentric randomized controlled trial with a 12-months follow-up, conducted in the French Valley Loire region from May 2009 to April 2013. Participants were working-aged patients with chronic low back pain referred to a French chronic low back pain care-network to support medical and occupational issues. Three treatment strategies, each for five weeks were compared: (i) intensive and multidisciplinary program conducted in a rehabilitation center; (ii) less intensive outpatient program conducted by a trained private physiotherapist; (iii) mixed strategy combining the same outpatient program associated with a weekly multidisciplinary intervention. The effects of treatment conditions were compared using an "intention to treat" approach: Number of days' sick leave during the 12-months following treatment, and quality of life and social ability assessed by auto-questionnaires. RESULTS: A total of 159 patients (58.9% men, 41.5± 10.3 years old, median duration of sick leave = 221.0 days (127.5-319.0)) were included. Sick leave duration significantly decreased during the 12-months following treatment in the three groups. There was no significant difference for the evolution of participants' quality of life, social ability, and personal beliefs between the three groups. CONCLUSION: This study confirms that disparate treatments might show similar effectiveness because they could all work through concomitant changes in beliefs, attitudes, and coping mechanisms. The original mixed strategy can treat a larger number of chronic low back pain patients, at a lower cost and provide local community-based care. CLINICAL TRIAL REGISTRATION: NCT02030171.
RCT Entities:
OBJECTIVE: To compare the effectiveness of three treatment strategies for chronic low back pain with varying biomechanical intensity and multidisciplinary approach. METHODS: A monocentric randomized controlled trial with a 12-months follow-up, conducted in the French Valley Loire region from May 2009 to April 2013. Participants were working-aged patients with chronic low back pain referred to a French chronic low back pain care-network to support medical and occupational issues. Three treatment strategies, each for five weeks were compared: (i) intensive and multidisciplinary program conducted in a rehabilitation center; (ii) less intensive outpatient program conducted by a trained private physiotherapist; (iii) mixed strategy combining the same outpatient program associated with a weekly multidisciplinary intervention. The effects of treatment conditions were compared using an "intention to treat" approach: Number of days' sick leave during the 12-months following treatment, and quality of life and social ability assessed by auto-questionnaires. RESULTS: A total of 159 patients (58.9% men, 41.5 ± 10.3 years old, median duration of sick leave = 221.0 days (127.5-319.0)) were included. Sick leave duration significantly decreased during the 12-months following treatment in the three groups. There was no significant difference for the evolution of participants' quality of life, social ability, and personal beliefs between the three groups. CONCLUSION: This study confirms that disparate treatments might show similar effectiveness because they could all work through concomitant changes in beliefs, attitudes, and coping mechanisms. The original mixed strategy can treat a larger number of chronic low back painpatients, at a lower cost and provide local community-based care. CLINICAL TRIAL REGISTRATION: NCT02030171.
Authors: Frank D Buono; Seddon R Savage; Brianna Cerrito; Julianne O'Connell; Amir Garakani; Sigurd Ackerman; Christopher J Cutter Journal: J Pain Res Date: 2020-06-24 Impact factor: 3.133
Authors: Mariska De Wit; Bedra Horreh; Joost G Daams; Carel T J Hulshof; Haije Wind; Angela G E M de Boer Journal: BMC Public Health Date: 2020-10-27 Impact factor: 3.295