Effectiveness of a semi-intensive multidisciplinary outpatient rehabilitation program in chronic low back pain |
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| Authors: | Christophe Demoulin Stéphanie Grosdent Lucile Capron Marco Tomasella Pierre-René Somville Jean-Michel Crielaard Marc Vanderthommen |
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| Affiliation: | 1. Department of Motricity Sciences, Liege University, ISEPK, B21, allée des Sports 4, 4000 Liège, Sart-Tilman, Belgium;2. Physical Medicine and Rehabilitation Department, Liege University Hospital Centre, 4000 Liège, Sart-Tilman, Belgium;1. Harborview Medical Center, Anesthesiology and Pain Medicine, Box 359724, 325 Ninth Ave, Seattle, WA 98104, USA;2. Anesthesiology and Pain Medicine, UW Center for Pain Relief, University of Washington, 4225 Roosevelt Way Northeast, Box 354693, Seattle, WA 98105, USA;1. Department of Sport and Rehabilitation Sciences, University of Liege, ISEPK BAT B21, Sart-Tilman, 4000 Liège, Belgium;2. Department of Physical Medicine and Rehabilitation, Liège University Hospital, Sart Tilman, 4000 Liège, Belgium;3. Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, P.O. Box 616, 6200 Maastricht, The Netherlands;4. Pain Clinic, Liège University Hospital, Sart Tilman, 4000 Liège, Belgium;5. Department of Psychology, Research Group on Health Psychology, University of Leuven, Tiensestraat 102, box 3726, 3000 Leuven, Belgium;1. Department of Orthopaedic Surgery and Traumatology, University Hospital of Heidelberg, Ruprecht-Karls-University of Heidelberg, Germany;2. Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University of Heidelberg, Germany;3. Spinal Cord Injury Center, University Hospital of Heidelberg, Ruprecht-Karls-University of Heidelberg, Germany;1. Département d’anesthésie-réanimation, Percy military teaching hospital, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France;2. Département d’anesthésie-réanimation, hôpital Antoine-Béclère, Assistance publique–Hôpitaux de Paris, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France;3. Service de gynécologie-obstétrique, hôpital Antoine-Béclère, Assistance publique–Hôpitaux de Paris, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France;4. Service d’hématologie biologique, hôpital Antoine-Béclère, Assistance publique–Hôpitaux de Paris, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France |
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| Abstract: | ObjectivesTo evaluate the efficacy of a semi-intensive multidisciplinary outpatient program complying with the requirements of the Belgian National Institute for Health and Disability Insurance and intended for patients with chronic low back pain.MethodsWe included 262 patients with nonspecific chronic low back pain, among whom 136 (73 women and 63 men) with a mean pain duration of 11.3 years completed the outpatient program (36 sessions each lasting 2 h). The program consisted of education about back-sparing techniques, interventions by an occupational therapist and psychologist, and physical reconditioning. Three sessions (sessions 1, 18, and 36) were used to evaluate pain intensity, functional impairment, kinesiophobia, cognitive knowledge, knowledge of appropriate spinal movement technique, and physical performance (trunk muscle strength and endurance, mobility of the pelvis and lumbar spine, and aerobic capacity).ResultsAll study variables were significantly improved at study completion compared to baseline: pain intensity was decreased by 44%, functional impairment by 40%, and kinesiophobia by 11% whereas knowledge was improved by 59%, back-sparing technique by 95%, trunk muscle strength by 40% on average, trunk extensor muscle endurance by 90%, mobility by 8%, and aerobic capacity by 18%.ConclusionsA semi-intensive multidisciplinary outpatient program was beneficial in patients with chronic low back pain. Careful patient selection and increased patient involvement in the program may help to improve adherence. |
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