Population
207 patients 18-60 years (52% female) with LBP for at least 4 out of the last 12 months with the last 14 days =/>4/10 on a VAS. If they had leg pain, the back pain had to be a worse complaint. All subjects made it through the study with no drop out in either group (impressive!)
Treatment Groups
Group 1 (EDUC): 105 Subjects received an educational approach designed to improve confidence in the robustness of the spine and two movements: Seated flexion and rotation
Group 2: 102 Subjects received Symptom Classification Based Treatment – MDT (by certified MDT) Directional preference, Stabilization, or intensive dynamic exercise. IN ADDITION: group 2’s physical therapists could at their own discretion referred for pharmacology, manual therapy, or physician for injection to complement their symptom-based plan
Outcome Measures
Pain, Activity Limitation, FABQ, Back Beliefs, physical activity, work ability, quality of life
Results
Primary Outcomes: Non-significant trend towards activity limitation being reduced mostly in the educational group although this could not be determined as clinically relevant.
Secondary outcomes: Improvement in fear-avoidance beliefs was better in the educational group. All other variables were about equally influenced by the two treatments.
The median number of treatment sessions was 3 for the educational group and 6 for the physical training group.
Conclusion:
“We have demonstrated that, among patients with cLBP, the educational/cognitive intervention with few consultations was at least as effective as an individualized, multidisciplinary physical-training approach. ‘At least’ refers to the observed overall trend of more improvement in activity-limitation with EDUC.”
“There was a statistically significant difference at 2 months in favor of EDUC in the proportion of people improving by a Minimal Important Change (MIC) in activity-limitation (5 or more points on the LBP Rating Scale).
“Post-hoc regression analysis showed a relationship between improved activity limitation and improvement in FABQ, and FABQ was more improved in the EDUC group at all three follow-ups, on balance these data appear to favor the EDUC approach.”
Full article Available Here.
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