Home > Journals > European Journal of Physical and Rehabilitation Medicine > Past Issues > Articles online first > European Journal of Physical and Rehabilitation Medicine 2017 Aug 29

CURRENT ISSUE
 

ARTICLE TOOLS

Publication history
Reprints
Cite this article as

EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,827


eTOC

 

European Journal of Physical and Rehabilitation Medicine 2017 Aug 29

DOI: 10.23736/S1973-9087.17.04716-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Effectiveness of subgroup-specific pain rehabilitation: a randomized controlled trial in patients with chronic back pain

Martin L. VERRA 1, 2 , Felix ANGST 1, Roberto BRIOSCHI 1, Susanne LEHMANN 1, Thomas BENZ 1, André AESCHLIMANN 1, Rob A. DE BIE 3, J. Bart STAAL 4

1 Rehabilitation Clinic RehaClinic, Bad Zurzach, Switzerland; 2 Department of Physiotherapy, Insel Group, Bern University Hospital, Berne, Switzerland; 3 Department of Epidemiology and Caphri Research School, Maastricht University, Maastricht, The Netherlands; 4 Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands


PDF  


BACKGROUND: Prospective classification of patients with nonspecific chronic back pain into homogeneous subgroups might be an important objective in order to tailor interventions and improve treatment outcomes.
AIM: This study investigated the effect of a subgroup-specific pain rehabilitation program based on the Multidimensional Pain Inventory (MPI) Classification System compared to standard care. DESIGN: Single blinded, parallel group, pragmatic randomized controlled trial.
SETTING: Inpatient subjects of a rehabilitation clinic.
POPULATION: A total of 139 patients with chronic back pain.
METHODS: Patients in both the experimental group and control group received during their 4-week in-house stay at the rehabilitation clinic on average four daily sessions of therapy. The patients in the experimental group received specific interventions, which were tailored to their subgroup classification profile. The patients in the control group participated in state-of-the-art care. The primary outcome was self-reported disability measured at 1, 3 and 12 months after randomization with the Oswestry Disability Index (ODI). Secondary outcomes were pain intensity, examiner-reported disability, anxiety and depression, catastrophizing, self-efficacy and global perceived effect.
RESULTS: Groups were comparable under demographic and clinical characteristics. No significant differences between the experimental group and the control group for any of the outcomes and follow-up times were found in the intention-to-treat analysis. Compared to the 8-10 points considered as minimal clinically important difference for the ODI, effects within groups were small, e.g. the experimental group improved by 2.2 points at 1 month follow up, 3.7 points at 3 months and 5.3 points at 12 months.
CONCLUSIONS: This study failed to demonstrate that a subgroup-specific program was more effective than standard care.
CLINICAL REHABILITATION IMPACT: Since the subgroup-specific interventions were equally effective as standard pain rehabilitation, subgroup classification and tailoring interventions may be an alternative in clinical care.


KEY WORDS: Back pain - Rehabilitation - Physical therapy modalities

top of page

Publication History

Article first published online: August 29, 2017
Manuscript accepted: August 25, 2017
Manuscript revised: July 18, 2017
Manuscript received: March 3, 2017

Cite this article as

Verra ML, Angst F, Brioschi R, Lehmann S, Benz T, Aeschlimann A, et al. Effectiveness of subgroup-specific pain rehabilitation: a randomized controlled trial in patients with chronic back pain. Eur J Phys Rehabil Med 2017 Aug 29. DOI: 10.23736/S1973-9087.17.04716-5

Corresponding author e-mail

martin.verra@insel.ch