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Quality of life improved by multidisciplinary back school program in patients with chronic non-specific low back pain: a single blind randomized controlled trial
Morone G, Paolucci T, Alcuri MR, Vulpiani MC, Matano A, Bureca I, Paolucci S, Saraceni VM
European Journal of Physical and Rehabilitation Medicine 2011 Dec;47(4):533-541
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; 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*

STUDY DESIGN: A three and six months follow-up in a randomized controlled trial. BACKGROUND: Back School has become a widespread exercise program for low back pain (LBP), since its introduction in 1969. Back school could improve quality of life (QoL), but there are controversial data regarding its effectiveness. AIM: To evaluate the effects of the back school program on quality of life (primary outcome), disability and pain perceptions (secondary outcomes) in patients with chronic and non-specific low back pain. SETTING: Rehabilitative specialized centre. POPULATION: Seventy four patients with chronic non-specific LBP. METHODS: Patients were randomly placed in a 3:2 form and were allocated into 2 groups (treated-control). Treatment group participated in a intensive multidisciplinary back school program including brief education and active back exercises (BSG, n = 41), while the control group received medical assistance (CG, n = 29). Medication was the same in both groups. The Short Form 36 Health Status Survey, Waddel Index, Oswestry Disability Index and visual analogue scale were collected at baseline, at the end of treatment, and at the three and six month follow-up. RESULTS: Quality of life significantly improved along time more in BSG, both in Physical and Mental Composite Score (repeated measure Anova: interaction time per group: p < 0.001 and p = 0.002, respectively). We also observed a significant improvement in disability scores along time (p < 0.001) in BSG with significant differences between groups at three and at six months for Waddell Index (p = 0.006 and p = 0.009 respectively) and for Oswestry Disability Index (p = 0.018 and 0.011 respectively). Moreover, pain perception score VAS showed a reduction in both groups, but it was significantly lower in BSG at end of treatment and both follow-ups (p < 0.001). CONCLUSION: Our back school program can be considered an effective treatment in people with chronic non-specific LBP.

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