General group exercise in low back pain management in a military population, a comparison with specific spine group exercise: a service evaluation

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Objective: To investigate whether general group exercise (GGE) offers the same outcomes when compared with a specific spinal group exercise (SSGE) for chronic low back pain (CLBP) in a military population.

Design: Retrospective service evaluation using routine service activity data.

Setting: A UK military rehabilitation centre.

Participants: A total of 106 CLBP patients.

Interventions: Three-week intensive (five days per week, 15-day intervention) rehabilitation course for patients with CLBP. Six SSGE groups (n= 64); CLBP only. Six GGE groups (n=42); CLBP patients grouped with chronic lower limb injuries.

Outcome Measures: Oswestry Disability Index (ODI), Numerical Pain-Rating Scores (NPRS) and the Modified Multi-Stage Fitness Test (Mod-MSFT). Long term effects were measured by Medical Employment Standard (MES) status and physiotherapy follow-up at three and 12 months.

Results: A between-group analysis showed no significant difference in GGE compared to SSGE. Mean changes (standard deviation) in pain were -2.71 ±2.35 and -1.20 ±1.99 (p=0.018), ODI were -3.6±5.7 and -4±8.5 respectively (p = 0.649) and Mod-MSFT 28.4±30.8 and 29.7±31.7 respectively (p = 0.792). At three months, a greater proportion of the GGE were having on-going physiotherapy; GGE = 50%, SSGE = 30.2%, (p = 0.016) although, some differences were evident across MES with 32.5% of GGE compared to 20.6% of SSGE being medically fit with no restrictions. . At 12 months, groups were largely comparable for follow up physiotherapy and MES; 22.5% of GGE and 20.6% of SSGE continued to have physiotherapy input; 47.5% of GGE and 50.8% of SSGE medically fit with no restrictions.

Conclusion: Patients with CLBP who completed a 3-week rehabilitation programme had comparable outcomes when grouped with LL patients, although only improvements in pain in the GGE group achieved a meaningful change. Further evaluation of potential costs and savings to service costs are now required.


Original languageEnglish
JournalJournal of the Royal Army Medical Corps
Early online date30 Oct 2018
Publication statusE-pub ahead of print - 30 Oct 2018


  • chronic low back pain, group therapy, exercise, service evaluation