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The efficacy of a short education program and a short physiotherapy program for treating low back pain in primary care: a cluster randomized trial.
Spine (Phila Pa 1976). 2010 Mar 01; 35(5):483-96.S

Abstract

STUDY DESIGN

Cluster randomized clinical trial.

OBJECTIVE

To assess the efficacy of a short education program and short physiotherapy program for treating low back pain (LBP) in primary care.

SUMMARY OF BACKGROUND DATA

There is sparse evidence on the effectiveness of education and physiotherapy programs that are short enough to be feasible in primary care.

METHODS

Sixty-nine primary care physicians were randomly assigned to 3 groups and recruited 348 patients consulting for LBP; 265 (79.8%) were chronic. All patients received usual care, were given a booklet and received a consistent 15 minutes group talk on health education, which focused on healthy nutrition habits in the control group, and on active management for LBP in the "education" and "education + physiotherapy" groups. Additionally, in the "education + physiotherapy" group, patients were given a second booklet and a 15-minute group talk on postural hygiene, and 4 one-hour physiotherapy sessions of exercise and stretching which they were encouraged to keep practicing at home. The main outcome measure was improvement of LBP-related disability at 6 months. Patients' assessment and data analyses were blinded.

RESULTS

During the 6-month follow-up period, improvement in the "control" group was negligible. Additional improvement in the "education" and "education + physiotherapy" groups was found for disability (2.0 and 2.2 Roland Morris Questionnaire points, respectively), LBP (1.8 and 2.10 Visual Analogue Scale points), referred pain (1.3 and 1.6 Visual Analogue Scale points), catastrophizing (1.6 and 1.8 Coping Strategies Questionnaire points), physical quality of life (2.9 and 2.9 SF-12 points), and mental quality of life (3.7 and 5.1 SF-12 points).

CONCLUSION

The addition of a short education program on active management to usual care in primary care leads to small but consistent improvements in disability, pain, and quality of life. The addition of a short physiotherapy program composed of education on postural hygiene and exercise intended to be continued at home, increases those improvements, although the magnitude of that increase is clinically irrelevant.

Authors+Show Affiliations

Department of public Health, Regional Health Authority of Castilla-León, Valladolid, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20147875

Citation

Albaladejo, Celia, et al. "The Efficacy of a Short Education Program and a Short Physiotherapy Program for Treating Low Back Pain in Primary Care: a Cluster Randomized Trial." Spine, vol. 35, no. 5, 2010, pp. 483-96.
Albaladejo C, Kovacs FM, Royuela A, et al. The efficacy of a short education program and a short physiotherapy program for treating low back pain in primary care: a cluster randomized trial. Spine (Phila Pa 1976). 2010;35(5):483-96.
Albaladejo, C., Kovacs, F. M., Royuela, A., del Pino, R., & Zamora, J. (2010). The efficacy of a short education program and a short physiotherapy program for treating low back pain in primary care: a cluster randomized trial. Spine, 35(5), 483-96. https://doi.org/10.1097/BRS.0b013e3181b9c9a7
Albaladejo C, et al. The Efficacy of a Short Education Program and a Short Physiotherapy Program for Treating Low Back Pain in Primary Care: a Cluster Randomized Trial. Spine (Phila Pa 1976). 2010 Mar 1;35(5):483-96. PubMed PMID: 20147875.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The efficacy of a short education program and a short physiotherapy program for treating low back pain in primary care: a cluster randomized trial. AU - Albaladejo,Celia, AU - Kovacs,Francisco M, AU - Royuela,Ana, AU - del Pino,Rafael, AU - Zamora,Javier, AU - ,, PY - 2010/2/12/entrez PY - 2010/2/12/pubmed PY - 2010/5/26/medline SP - 483 EP - 96 JF - Spine JO - Spine (Phila Pa 1976) VL - 35 IS - 5 N2 - STUDY DESIGN: Cluster randomized clinical trial. OBJECTIVE: To assess the efficacy of a short education program and short physiotherapy program for treating low back pain (LBP) in primary care. SUMMARY OF BACKGROUND DATA: There is sparse evidence on the effectiveness of education and physiotherapy programs that are short enough to be feasible in primary care. METHODS: Sixty-nine primary care physicians were randomly assigned to 3 groups and recruited 348 patients consulting for LBP; 265 (79.8%) were chronic. All patients received usual care, were given a booklet and received a consistent 15 minutes group talk on health education, which focused on healthy nutrition habits in the control group, and on active management for LBP in the "education" and "education + physiotherapy" groups. Additionally, in the "education + physiotherapy" group, patients were given a second booklet and a 15-minute group talk on postural hygiene, and 4 one-hour physiotherapy sessions of exercise and stretching which they were encouraged to keep practicing at home. The main outcome measure was improvement of LBP-related disability at 6 months. Patients' assessment and data analyses were blinded. RESULTS: During the 6-month follow-up period, improvement in the "control" group was negligible. Additional improvement in the "education" and "education + physiotherapy" groups was found for disability (2.0 and 2.2 Roland Morris Questionnaire points, respectively), LBP (1.8 and 2.10 Visual Analogue Scale points), referred pain (1.3 and 1.6 Visual Analogue Scale points), catastrophizing (1.6 and 1.8 Coping Strategies Questionnaire points), physical quality of life (2.9 and 2.9 SF-12 points), and mental quality of life (3.7 and 5.1 SF-12 points). CONCLUSION: The addition of a short education program on active management to usual care in primary care leads to small but consistent improvements in disability, pain, and quality of life. The addition of a short physiotherapy program composed of education on postural hygiene and exercise intended to be continued at home, increases those improvements, although the magnitude of that increase is clinically irrelevant. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/20147875/The_efficacy_of_a_short_education_program_and_a_short_physiotherapy_program_for_treating_low_back_pain_in_primary_care:_a_cluster_randomized_trial_ DB - PRIME DP - Unbound Medicine ER -