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Cited by 93Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationSpine and Intervertebral Disc Pathology

Treatment of Chronic Low Back Pain: A Randomized, Clinical Trial Comparing Group-Based Multidisciplinary Biopsychosocial Rehabilitation and Intensive Individual Therapist-Assisted Back Muscle Strengthening Exercises

Dufour, Ninna, Thamsborg, Gorm, Oefeldt, Alex, Lundsgaard, Charlotte, Stender, Steen·2010·Spine
DOI 10.1097/brs.0b013e3181b8db2e
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Abstract

STUDY DESIGN: A stratified randomized single-blinded clinical trial. OBJECTIVE: To compare the efficacies of 2 active therapies for chronic low back pain (CLBP). SUMMARY OF BACKGROUND DATA: Both a multidisciplinary biopsychosocial rehabilitation program and an intensive individual therapist-assisted back muscle strengthening exercise program used in Denmark have been reported to be effective for the treatment of CLBP. METHODS: A total of 286 patients with CLBP were randomized to either a group-based 12-week program comprising 73 hours of therapist exposure (approximately 12 h/patient): 35 hours of hard physical exercise, 22 hours of light exercise/occupational therapy, and 16 hours of education (group A) or a 12-week program comprising 1 hour of personal training twice a week, i.e., therapist exposure 24 h/patient (group B). At baseline and at 3, 6, 12, and 24 months, patients filled out questionnaires on pain (visual analogue scale [VAS]-pain average, which was the primary outcome measure), Roland-Morris disability questionnaire, global perceived outcome, and 36-Item Short-Form General Health Survey. Data were analyzed using the intention-to-treat principle. RESULTS: Of the 286 patients, 14 patients did not start treatment. Of the remaining patients, 25 (9%) dropped out of therapy. The 2 groups were comparable regarding baseline characteristic. After treatment, significant improvements were observed with regard to pain, disability, and most of the quality of life dimensions. These effects were sustained over the 24-month follow-up period. There were some statistically significant differences between the 2 groups relating to secondary end points, Roland-Morris disability questionnaire, and in the MOS 36-Item Short-Form Health Survey the "physical functioning" dimension and the "physical component summary." CONCLUSION: Both groups showed long-term improvements in pain and disability scores, with only minor statistically significant differences between the 2 groups. The minor outcome difference in favor of the group-based multidisciplinary rehabilitation program is hardly of clinical interest for individual patients.

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  • Evidence is conflicting for the effectiveness of combined psychological approaches delivered with physiotherapy care for improving health related quality of life compared with physiotherapy care alone.

    “Evidence is conflicting for the effectiveness of combined psychological approaches delivered with physiotherapy care for improving health related quality of life, compared with physiotherapy care alone (ranging from no effect90 to a significant effect at short term91 or long term follow-up92 93).”

    From Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis (2022) · cites this paper as [91]

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Authors
Dufour, N., Thamsborg, G., Oefeldt, A., Lundsgaard, C., & Stender, S.
Affiliations
  • Glostrup Hospital (DK)
  • Gentofte Hospital (DK)
Corresponding author
  • Dufour, Ninna
  • Thamsborg, Gorm
  • Lundsgaard, Charlotte
ORCID
Stender, Steen
Venue
Spine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-03
Volume
35
Issue
5
Pages
469-476
ISSN
0362-2436 (ISSN-L)
DOI
10.1097/brs.0b013e3181b8db2e
OpenAlex
W2070580166
Cited by
92
References
46
Citations by year
2026: 2 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 7 · 2021: 8 · 2020: 7 · 2019: 5 · 2018: 5 · 2017: 3 · 2016: 5 · 2015: 5 · 2014: 6 · 2013: 9 · 2012: 8
FWCI
6.61
Type
journal article
Language
en
Open access
closed
Locations
  • Spine (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Keywords
chronic low back pain, multidisciplinary rehabilitation, biopsychosocial rehabilitation, pain intensity, disability, quality of life, long-term treatment outcomes, physical activity
MeSH terms
Analysis of Variance, Chronic Disease, Combined Modality Therapy, Denmark, Exercise Therapy, Female, Health Status, Humans, Male, Pain Measurement, Patient Education as Topic, Prospective Studies, Quality of Life, Surveys and Questionnaires, Severity of Illness Index, Time Factors, Single-Blind Method, Treatment Outcome, Low Back Pain, Intention to Treat Analysis

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