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Effectiveness of different interventions using a psychosocial subgroup assignment in chronic neck and back pain patients: a 10-year follow-up [with consumer summary]
Bergstrom C, Jensen I, Hagberg J, Busch H, Bergstrom G
Disability and Rehabilitation 2012;34(2):110-118
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: The aim of this study was to evaluate the potential interaction between treatment content and subgroups according to the Swedish version of the Multidimensional Pain Inventory (MPI-S) on the effect on sickness absence during a 10-year follow-up in a population with chronic neck pain (NP) and/or low back pain (LBP). METHODS: This study is based on a randomized controlled multicentre trial with a 10-year follow-up using the MPI-S and included 214 participants. The interventions consisted of behavioural-oriented physiotherapy (PT), cognitive behavioural therapy (CBT), behavioural medicine rehabilitation (BM), and a "treatment-as-usual" control group (CG). RESULTS: There appears to be a difference in the development of sickness absence after rehabilitation for the adaptive coper (AC) group even though the result did not reach statistical significance. AC seems to respond most favourably to the multidisciplinary programme compared to the CG. The development of sickness absence after intervention among interpersonally distressed (ID) and dysfunctional (DYS) patients were similar across all three treatment alternatives as well as CG. CONCLUSION: In terms of long-term follow-up of sickness absence, the multidisciplinary programme appears to be most beneficial for DYS and AC patients. In contrast, the CBT and PT interventions failed to benefit any patient group.

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