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Efficacy and treatment compliance of a home-based rehabilitation programme for chronic low back pain: a randomized, controlled study
Ben Salah Frih Z, Fendri Y, Jellad A, Boudoukhane S, Rejeb N
Annals of Physical and Rehabilitation Medicine 2009 Jul;52(6):485-496
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; 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*

OBJECTIVE: To assess the efficacy and treatment compliance of a home-based rehabilitation programme for chronic low back pain (CLBP). POPULATION: CLBP outpatients treated in a Physical Medicine Rehabilitation or Rheumatology unit within a university hospital. METHODS: We performed a prospective, comparative study. The participants were randomly assigned to either a home-based rehabilitation programme (gp A) or a standard physical therapy (gp B). The programme included four weekly sessions. In each group, we measured pain intensity (on a visual analogue scale, VAS), flexibility and muscle endurance (the Schober MacRae test, finger-to-floor distance, thigh-leg angle, the Shirado and Sorensen test), functional and psychological repercussions (the Quebec functional index and the Hospital Anxiety and Depression scale) and handicap (on a VAS). Follow-up examinations took place at baseline and four weeks and three, six and 12 months later. RESULTS: One hundred and seven patients (82 women) with a mean+/-standard deviation (SD) age of 35.7 +/- 0.8 years were included (with 54 patients in gp A). At four weeks, a significant improvement (relative to baseline) was observed for all parameters in both study groups but with a significantly greater difference in gp A, which was maintained at one year (despite an observed regression of the improvement at six months). At one year, compliance with the home-based rehabilitation programme was good (68.1%) and 59.5% of the patients regarded the programme as useful. CONCLUSION: Our results suggest that a home-based rehabilitation programme is as effective as standard physical therapy. However, this type of programme requires patient motivation and regular follow-up.

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