Abstract
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.
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 language | English |
|---|---|
| Journal | Journal of the Royal Army Medical Corps |
| Early online date | 30 Oct 2018 |
| DOIs | |
| Publication status | E-pub ahead of print - 30 Oct 2018 |
Keywords
- chronic low back pain
- group therapy
- exercise
- service evaluation