Implementation of a Multidisciplinary Program for Active Duty Personnel Seeking Care for Low Back Pain in a U.S. Navy Medical Center: A Feasibility Study
Abstract
The aim of the pilot study was to evaluate a multidisciplinary program for nonspecific low back pain (NSLBP) at a major U.S. Navy base. In this single blinded randomized clinical trial, subjects were drawn from a larger, prospective cohort of active duty service members seeking care for NSLBP pain at a U.S. Navy Branch Medical Clinic. Outcome measures included return to work, self-reported pain, function, and psychological distress. Subjects were randomly allocated to one of two study arms: a multidisciplinary reconditioning program or the current standard of care for low back pain. The intervention lasted 4 weeks with a 12-week follow-up. Thirty-three subjects were enrolled. Subjects allocated to multidisciplinary care reported significantly lower perceived disability (p = 0.014) and less pain than those allocated to usual care at the end of the intervention period. All subjects returned to their usual duty following the conclusion of the intervention. The implementation of the intervention program was successful. Subjects in the multidisciplinary program showed a clinically significant improvement in the perception of disability compared to the usual care group. This is an important finding since perception of disability is associated with long-term functional outcome.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The combination of both exercise and cognitive interventions in this DCP may explain the greater improvement.
“Indeed, the combination of both exercise and cognitive interventions in this DCP may explain the greater improvement, in agreement with the findings of Campello et al., [64] who reported a 47.5% improvement in NPRS in subacute low back pain with exercise plus CBT.”
From Telerehabilitation of acute musculoskeletal multi-disorders: prospective, single-arm, interventional study (2022) · cites this paper as [64]
Pain reductions observed in this study were higher than those reported in papers detailing other non-digital interventions.
“Pain reductions observed in this study were higher than those reported in papers detailing other non-digital interventions [63–65].”
From Telerehabilitation of acute musculoskeletal multi-disorders: prospective, single-arm, interventional study (2022) · cites this paper as [64]
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
The Pain Catastrophizing Scale: Development and validation.
Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995) · Psychological Assessment · doi:10.1037//1040-3590.7.4.524 · Cited by 8,227 · see citing works
Bush, K. (1998) · Archives of Internal Medicine · doi:10.1001/archinte.158.16.1789 · Cited by 6,196 · see citing works
Oswestry Low Back Pain Disability Questionnaire
Fairbank, J. C. T., Couper, J., Davies, J. B., & O'Brien, J. P. (2006) · Springer eBooks · doi:10.1007/978-3-540-29805-2_3023 · Cited by 3,954 · see citing works
Waddell, G., Newton, M., Henderson, I., Somerville, D., & Main, C. J. (1993) · Pain · doi:10.1016/0304-3959(93)90127-b · Cited by 3,167 · see citing works
Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance
Vlaeyen, J. W. S., Kole-Snijders, A. M. J., Boeren, R. G. B., & van Eek, H. (1995) · Pain · doi:10.1016/0304-3959(94)00279-n · Cited by 2,446 · see citing works
Waddell, G. (2004) · Cited by 1,262 · see citing works
Multidisciplinary rehabilitation for chronic low back pain: systematic review
Guzmán, J., Esmail, R., Karjalainen, K., Malmivaara, A., Irvin, E., & Bombardier, C. (2001) · BMJ · doi:10.1136/bmj.322.7301.1511 · Cited by 941 · see citing works
Melzack, R., & Torgerson, W. S. (1971) · Anesthesiology · doi:10.1097/00000542-197101000-00017 · Cited by 930 · see citing works
Bliese, P. D., Wright, K. M., Adler, A. B., Cabrera, Ó., Castro, C. A., & Hoge, C. W. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.2.272 · Cited by 733 · see citing works
Lindström, I., Öhlund, C., Eek, C., Wallin, L., Peterson, L., Fordyce, W. E., & NACHEMSON, A. L. (1992) · Physical Therapy · doi:10.1093/ptj/72.4.279 · Cited by 532 · see citing works
Fritz, J. M., George, S. Z., & Delitto, A. (2001) · Pain · doi:10.1016/s0304-3959(01)00333-5 · Cited by 513 · see citing works
George, S., Fritz, J., Bialosky, J., & Donald, D. A. (2003) · Spine · doi:10.1097/01.brs.0000096677.84605.a2 · Cited by 299 · see citing works
Multidisciplinary biopsychosocial rehabilitation for subacute low-back pain among working age adults
Karjalainen, K. A., Malmivaara, A. V., van Tulder, M. W., Roine, R. P., Jauhiainen, M., Hurri, H., & Koes, B. W. (2003) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002193 · Cited by 259 · see citing works
Progressive Isoinertial Lifting Evaluation
Mayer, T. G., BARNES, D., Kishino, N. D., NICHOLS, G., Gatchel, R. J., MAYER, H., & Mooney, V. (1988) · Spine · doi:10.1097/00007632-198809000-00005 · Cited by 220 · see citing works
Linton, S. J., Boersma, K., Jansson, M., Sv??rd, L., & Botvalde, M. (2005) · The Clinical Journal of Pain · doi:10.1097/00002508-200503000-00001 · Cited by 196 · see citing works
Cohen, S. P., Brown, C. H., Kurihara, C., Plunkett, A., Nguyen, C., & Strassels, S. A. (2010) · The Lancet · doi:10.1016/s0140-6736(09)61797-9 · Cited by 188 · see citing works
Progressive Isoinertial Lifting Evaluation
Mayer, T. G., BARNES, D., NICHOLS, G., Kishino, N. D., COVAL, K., PIEL, B., HOSHINO, D., & Gatchel, R. J. (1988) · Spine · doi:10.1097/00007632-198809000-00006 · Cited by 147 · see citing works
Do Functional Tests Predict Low Back Pain?
Takala, E., & Viikari‐Juntura, E. (2000) · Spine · doi:10.1097/00007632-200008150-00018 · Cited by 90 · see citing works
Schiltenwolf, M., Buchner, M., Heindl, B., von Reumont, J., Müller, A. M., & Eich, W. (2005) · European Spine Journal · doi:10.1007/s00586-005-0008-5 · Cited by 85 · see citing works
Preliminary Findings of a Randomized Controlled Trial of an Interdisciplinary Military Pain Program
Gatchel, R. J., McGeary, D. D., Peterson, A. L., Moore, M., LeRoy, K., Isler, W. C., Hryshko‐Mullen, A., & Edell, T. (2009) · Military Medicine · doi:10.7205/milmed-d-03-1607 · Cited by 57 · see citing works
Predictors of Navy Attrition. I. Analysis of 1-Year Attrition
Booth‐Kewley, S., Larson, G. E., & Ryan, M. A. K. (2002) · Military Medicine · doi:10.1093/milmed/167.9.760 · Cited by 54 · see citing works
Nordin, M. C., Balagué, F., & Cedraschi, C. (2006) · Clinical Orthopaedics and Related Research · doi:10.1097/01.blo.0000198721.75976.d9 · Cited by 45 · see citing works
Self-citationHIEBERT, R. N., Campello, M. A., Weiser, S. R., Ziemke, G. W., Fox, B., & Nordin, M. C. (2012) · The Spine Journal · doi:10.1016/j.spinee.2011.11.012 · Cited by 39 · see citing works
Self-citationLitow, F. K., & Krahl, P. L. (2007) · Military Medicine · doi:10.7205/milmed.172.12.1270 · Cited by 26 · see citing works
Work Retention and Nonspecific Low Back Pain
Campello, M. A., Weiser, S. R., Nordin, M. C., & HIEBERT, R. N. (2006) · Spine · doi:10.1097/01.brs.0000227288.00378.d5 · Cited by 18 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Multidisciplinary biopsychosocial rehabilitation for chronic low back pain
Kamper, S. J., Apeldoorn, A. T., Chiarotto, A., Smeets, R. J. E. M., Ostelo, R. W., Guzman, J., & van Tulder, M. W. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000963.pub3 · Cited by 629 · see citing works
Multidisciplinary biopsychosocial rehabilitation for subacute low back pain
Marin, T. J., Eerd, D. V., Irvin, E., Couban, R., Koes, B. W., Malmivaara, A. V., van Tulder, M. W., & Kamper, S. J. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002193.pub2 · Cited by 175 · see citing works
Costa, F., Janela, D., Molinos, M., Lains, J., Francisco, G. E., Bento, V., & Dias Correia, F. (2022) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-021-04891-5 · Cited by 35 · see citing works
Daley, D., Payne, L. P., Galper, J. S., Cheung, A., Deal, L., Despres, M., Garcia, J. D., Kistner, F., Mackenzie, N., Perry, T., et al. (2021) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2021.0303 · Cited by 34 · see citing works
Nascimento, D. P., Costa, L. O. P., Gonzalez, G. Z., Maher, C. G., & Moseley, A. M. (2019) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2019.03.024 · Cited by 30 · see citing works
Cancelliere, C., Sutton, D. A., Côté, P., French, S. D., Taylor-Vaisey, A. L., & Mior, S. A. (2019) · Implementation Science · doi:10.1186/s13012-019-0931-1 · Cited by 22 · see citing works
A New Approach to Managing Patients with Problematic Metal Hip Implants
Berber, R., Pappas, Y., Khoo, M. M. Y., Miles, J., Carrington, R., Skinner, J. A., & Hart, A. J. (2015) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.n.00973 · Cited by 18 · see citing works
Bounds, C. L., Coppieters, M. W., Thomson, H., Larsen, B., & Evans, K. A. (2023) · Military Medicine · doi:10.1093/milmed/usac409 · Cited by 13 · see citing works
Monticone, M., AMBROSINI, E., Portoghese, I., & ROCCA, B. (2021) · European Journal of Physical and Rehabilitation Medicine · doi:10.23736/s1973-9087.21.06696-x · Cited by 11 · see citing works
RetractedWeiser, S., Lis, A., Ziemke, G., Hiebert, R., Faulkner, D., Brennan, T., Iveson, B., & Campello, M. (2018) · Military Medicine · doi:10.1093/milmed/usx229 · Cited by 8 · see citing works
Self-citationDigital Rehabilitation for Acute Low Back Pain: A Prospective Longitudinal Cohort Study
Costa, F. M. T. A., Janela, D., Molinos, M., Moulder, R. G., Jr., Laíns, J., Bento, V., Scheer, J. K., Yanamadala, V., Correia, F. D., & Cohen, S. P. (2022) · Journal of Pain Research · doi:10.2147/jpr.s369926 · Cited by 8 · see citing works
Ziemke, G. W., Campello, M. A., HIEBERT, R. N., Weiner, S. S., Rennix, C. P., & Nordin, M. C. (2015) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-015-4328-4 · Cited by 8 · see citing works
Self-citationIntegrated and Comprehensive Pain Management Programs: Effectiveness and Harms
Skelly, A. C., Chou, R., Dettori, J. R., Brodt, E., Diulio-Nakamura, A., Mauer, K., Fu, R., Yu, Y., Wasson, N., Kantner, S. N., et al. (2021) · doi:10.23970/ahrqepccer251 · Cited by 9 · see citing works
Spinal Injuries and Spine Care in the U.S. Military Health System (2001–Present)
Holly, K. E., Hatton, M. O., Bryan, M. R., Freedman, B. A., Helgeson, M. D., Koehlmoos, T. P., & Schoenfeld, A. J. (2024) · Spine · doi:10.1097/brs.0000000000005199 · Cited by 7 · see citing works
McParland, J. L., Andrews, P., Kidd, L., Williams, L., & Flowers, P. (2021) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2020.1863809 · Cited by 4 · see citing works
Mowery, H. C., Campello, M. A., Ziemke, G. W., Oh, C., Hope, T., Jansen, B., & Weiser, S. R. (2024) · Military Medicine · doi:10.1093/milmed/usae019 · Cited by 5 · see citing works
Self-citationAustin, T. A., Rogers, R. E., Hodges, C. B., Kominek, C., Madaffer, N., Miller, J., & Shigaki, C. L. (2022) · Military Behavioral Health · doi:10.1080/21635781.2022.2029636 · Cited by 2 · see citing works
Perigny-Lajoie, S., & Hebert, J. S. (2016) · Journal of Military Veteran and Family Health · doi:10.3138/jmvfh.3972 · Cited by 1 · see citing works
Clinical and Imaging Assessment of Metal on Metal Hip Patients
Berber, R. (2019) · UCL Discovery (University College London)
Schoenfeld, A. J., Holly, K. E., Bryan, M. R., Hatton, M. O., Wien, M. F., & Koehlmoos, T. P. (2025) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2025.101108
- Authors
- Campello, M., Ziemke, G., Hiebert, R., Weiser, S., Brinkmeyer, M., Fox, B., Dail, J., Kerr, S., Hinnant, I., & Nordin, M.
- Affiliations
- NYU Langone Health (US)
- Naval Medical Center Portsmouth (US)
- Battelle (US)
- Venue
- Military Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-09
- Volume
- 177
- Issue
- 9
- Pages
- 1075-1080
- ISSN
- 0026-4075 (ISSN-L)
- 1930-613X
- OpenAlex
- W2312763738
- Cited by
- 20
- References
- 26
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 4 · 2019: 3 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 1
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Military Medicine (publishedVersion)
- PubMed (publishedVersion)
- 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
- non-specific low back pain, multidisciplinary pain management, active duty military personnel, return to work, perceptions of disability, pain intensity, psychological distress, military health services, feasibility
- MeSH terms
- Adult, Disability Evaluation, Feasibility Studies, Female, Humans, Male, Military Personnel, Pain Measurement, Pilot Projects, Surveys and Questionnaires, United States, Chi-Square Distribution, Single-Blind Method, Treatment Outcome, Low Back Pain, Statistics, Nonparametric, Recovery of Function
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
