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| Evaluating the effectiveness of a comprehensive education on low back pain treatment outcomes: a controlled clinical study [with consumer summary] |
| Kanaan SF, Alhendi ZM, Almhdawi KA, Aldahamsheh Z, Ismail N, Khalil H |
| Clinical Rehabilitation 2023 Jan;37(1):98-108 |
| clinical trial |
| 5/10 [Eligibility criteria: Yes; Random allocation: No; Concealed allocation: No; Baseline comparability: Yes; 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* |
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OBJECTIVES: To investigate the effect of integrating an individualized, evidence-based low back pain comprehensive education package on low back pain treatment outcomes. DESIGN: Single-blind, controlled clinical study using the alternate allocation of patients. SETTING: Outpatient clinic. SUBJECTS: In total, 54 participants with chronic low back pain (46.75 +/- 11.11 years, 80% females) were randomized to intervention (n = 27) or a control group (n = 27). INTERVENTION: The intervention group received additional four one-hour low back pain-related education sessions to eight 45 minutes standard physical therapy sessions over 4 weeks. OUTCOME MEASURES: Assessed at baseline, post-intervention, and 3 months. Outcome measures included pain intensity (Visual Analogue Scale), knowledge (Low Back Pain Knowledge Questionnaire), attitude (the Back Pain Attitudes Questionnaire), disability (the Oswestry Disability Index), mental health symptoms (Depression Anxiety Stress Scale, DASS-21 scale), and fear-avoidance (Fear-Avoidance Beliefs Questionnaire). RESULTS: The intervention group showed significantly lower pain intensity ((4 weeks (3.58 +/- 1.50 versus 5.54 +/- 1.92), 3 months (3.21 +/- 1.74 versus 5.69 +/- 2.51)), higher knowledge ((4 weeks (21.67 +/- 2.12 versus 11.62 +/- 3.47), three months (22.08 +/- 3.40 versus 12.23 +/- 3.24)), lower negative attitudes ((4 weeks (99.29 +/- 11.02 versus 134.31 +/- 12.97), 3 months (102.92 +/- 15.58 versus 132.42 +/- 17.79)), lower disability ((4 weeks (26.30 +/- 11.37 versus 45.14 +/- 18.67), 3 months (22.83 +/- 16.06 versus 44.13 +/- 15.02)), lower stress score ((4 weeks (3.54 +/- 3.01 versus 8.81 +/- 5.19), 3 months (3.21 +/- 3.22 versus 7.21 +/- 4.36)), lower anxiety ((4 weeks (2.63 +/- 3.16 versus 6.42 +/- 4.75), three months (2.63 +/- 3.80 versus 5.73 +/- 4.44)), lower depression ((4 weeks (2.42 +/- 2.15 versus 6.42 +/- 3.68), three months (2.63 +/- 4.18 versus 7.08 +/- 4.41)), and lower fear-avoidance ((4 weeks (13.88 +/- 12.32 versus 50.88 +/- 23.25), three months (15.50 +/- 16.75 versus 54.65 +/- 31.81)). CONCLUSION: Integrating low back pain comprehensive education into standard physical therapy might optimize the treatment outcomes of low back pain.
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