天美传媒

Abstract

Question: What are the 2-year outcomes of individualized-physiotherapy relative to advice for people with low back disorders? Design: Two-year follow-up of a randomized controlled trial (ACTRN12609000834257). Participants: 300 patients with a primary complaint of low back and/or referred leg pain. Interventions: Patients received either 10-sessions of physiotherapy that was individualized based on pathoanatomical, psychosocial, and neurophysiological barriers to recovery combined with guideline-based advice or 2-sessions of physiotherapist-delivered advice alone. Outcome measures: Primary outcomes were activity limitation (Oswestry Disability Index) and numerical rating scales for back and leg pain. Results: Between group differences for Oswestry favoured individualized-physiotherapy at 10-weeks (4.7; 95% CI 2.0 to 7.5), 26-weeks (5.4; 95% CI 2.6 to 8.2), 52-weeks (4.3; 95% CI 1.4 to 7.1) and 104-weeks (3.1; 95% CI 0.2 to 6.0). Back and leg pain were significantly lower in the physiotherapy group relative to the advice group at 10-weeks (Back: 1.3; 95% CI 0.8 to 1.8, Leg: 1.1; 95% CI 0.5 to 1.7) and 26-weeks (Back: 0.9; 95% CI 0.4 to 1.4, Leg: 1.0; 95% CI 0.4 to 1.6) time points. Responder analysis at 52-weeks showed patients receiving individualized-physiotherapy were more likely to improve by 50% from baseline for Oswestry (relative risk [RR] 1.5; 95%CI 1.2-1.8) and back pain (RR 1.3; 95%CI 1.2-1.8) than those receiving advice alone. Conclusion: Individualized-physiotherapy leads to greater reduction in long term activity limitation, back pain and leg pain compared to guideline-recommended advice. These differences appear to be clinically important.

Biography

Email: j.ford@latrobe.edu.au