Literature DB >> 9854761

Efficiency and costs of medical exercise therapy, conventional physiotherapy, and self-exercise in patients with chronic low back pain. A pragmatic, randomized, single-blinded, controlled trial with 1-year follow-up.

T A Torstensen1, A E Ljunggren, H D Meen, E Odland, P Mowinckel, S Geijerstam.   

Abstract

STUDY
DESIGN: A multicenter, randomized, single-blinded controlled trial with 1-year follow-up.
OBJECTIVES: To evaluate the efficiency of progressively graded medical exercise therapy, conventional physiotherapy, and self-exercise by walking in patients with chronic low back pain. SUMMARY AND BACKGROUND DATA: Varieties of medical exercise therapy and conventional physiotherapy are considered to reduce symptoms, improve function, and decrease sickness absence, but this opinion is controversial.
METHODS: Patients with chronic low back pain or radicular pain sick-listed for more than 8 weeks and less than 52 weeks (Sickness Certificate II) were included. The treatment lasted 3 months (36 treatments). Pain intensity, functional ability, patient satisfaction, return to work, number of days on sick leave, and costs were recorded.
RESULTS: Of the 208 patients included in this study, 71 were randomly assigned to medical exercise therapy, 67 to conventional physiotherapy, and 70 to self-exercise. Thirty-three (15.8%) patients dropped out during the treatment period. No difference was observed between the medical exercise therapy and conventional physiotherapy groups, but both were significantly better than self-exercise group. Patient satisfaction was highest for medical exercise therapy. Return to work rates were equal for all 3 intervention groups at assessment 15 months after therapy was started, with 123 patients were back to work. In terms of costs for days on sick leave, the medical exercise therapy group saved 906,732 Norwegian Kroner (NOK) ($122,531.00), and the conventional physiotherapy group saved NOK 1,882,560 ($254,200.00), compared with the self-exercise group.
CONCLUSIONS: The efficiency of medical exercise therapy and conventional physiotherapy is shown. Leaving patients with chronic low back pain untampered poses a risk of worsening the disability, resulting in longer periods of sick leave.

Entities:  

Mesh:

Year:  1998        PMID: 9854761     DOI: 10.1097/00007632-199812010-00017

Source DB:  PubMed          Journal:  Spine (Phila Pa 1976)        ISSN: 0362-2436            Impact factor:   3.468


  36 in total

1.  Routine primary care management of acute low back pain: adherence to clinical guidelines.

Authors:  Violeta González-Urzelai; Loreto Palacio-Elua; Josefina López-de-Munain
Journal:  Eur Spine J       Date:  2003-11-06       Impact factor: 3.134

Review 2.  The effectiveness of walking as an intervention for low back pain: a systematic review.

Authors:  P Hendrick; A M Te Wake; A S Tikkisetty; L Wulff; C Yap; S Milosavljevic
Journal:  Eur Spine J       Date:  2010-04-23       Impact factor: 3.134

Review 3.  Physical conditioning as part of a return to work strategy to reduce sickness absence for workers with back pain.

Authors:  Frederieke G Schaafsma; Karyn Whelan; Allard J van der Beek; Ludeke C van der Es-Lambeek; Anneli Ojajärvi; Jos H Verbeek
Journal:  Cochrane Database Syst Rev       Date:  2013-08-30

Review 4.  Outcome of non-invasive treatment modalities on back pain: an evidence-based review.

Authors:  Maurits W van Tulder; Bart Koes; Antti Malmivaara
Journal:  Eur Spine J       Date:  2005-12-01       Impact factor: 3.134

Review 5.  Consumer satisfaction with occupational health services: should it be measured?

Authors:  J Verbeek; F van Dijk; K Räsänen; H Piirainen; E Kankaanpää; C Hulshof
Journal:  Occup Environ Med       Date:  2001-04       Impact factor: 4.402

Review 6.  Evaluation of effective return-to-work treatment programs for sick-listed patients with non-specific musculoskeletal complaints: a systematic review.

Authors:  Eline M Meijer; Judith K Sluiter; Monique H W Frings-Dresen
Journal:  Int Arch Occup Environ Health       Date:  2005-06-15       Impact factor: 3.015

7.  Inter-tester Reliability in Classifying Acute and Subacute Low Back Pain Patients into Clinical Subgroups: A Comparison of Specialists and Non-Specialists. A Pilot Study.

Authors:  Markku Paatelma; Eira Karvqnen; Ari Heinqnen
Journal:  J Man Manip Ther       Date:  2009

8.  The back 2 activity trial: education and advice versus education and advice plus a structured walking programme for chronic low back pain.

Authors:  Suzanne M McDonough; Mark A Tully; Seán R O'Connor; Adele Boyd; Daniel P Kerr; Siobhán M O'Neill; Antony Delitto; Ian Bradbury; Catrine Tudor-Locke; David G Baxter; Deirdre A Hurley
Journal:  BMC Musculoskelet Disord       Date:  2010-07-15       Impact factor: 2.362

9.  A walking programme and a supervised exercise class versus usual physiotherapy for chronic low back pain: a single-blinded randomised controlled trial. (The Supervised Walking In comparison to Fitness Training for Back Pain (SWIFT) Trial).

Authors:  Deirdre A Hurley; Grainne O'Donoghue; Mark A Tully; Jennifer Klaber Moffett; Willem van Mechelen; Leslie Daly; Colin Ag Boreham; Suzanne M McDonough
Journal:  BMC Musculoskelet Disord       Date:  2009-07-02       Impact factor: 2.362

10.  Effectiveness of physical training for self-employed persons with musculoskeletal disorders: a randomized controlled trial.

Authors:  Judith Heinrich; Johannes R Anema; Ernest M M de Vroome; Birgitte M Blatter
Journal:  BMC Public Health       Date:  2009-06-23       Impact factor: 3.295

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