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Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial
Open AccessArticle

Multidisciplinary Pain Management of Chronic Back Pain: Helpful Treatments from the Patients’ Perspective

Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, 69118 Heidelberg, Germany
Klinik für Gynäkologie und Geburtshilfe, Marienhaus Klinikum Hetzelstift Neustadt/Weinstraße, 67434 Neustadt an der Weinstraße, Germany
Zentrum für ambulante Rehabilitation Mannheim GmbH, 68309 Mannheim, Germany
Author to whom correspondence should be addressed.
These authors contributed equally to this study.
J. Clin. Med. 2020, 9(1), 145;
Received: 20 November 2019 / Revised: 29 December 2019 / Accepted: 3 January 2020 / Published: 5 January 2020
(This article belongs to the Section Orthopedics)
Multidisciplinary pain management programs (MPMP) for patients suffering from chronic back pain include a variety of treatment modalities. The patients’ perceived helpfulness of these treatment modalities remains unclear. The aims of this prospective observational cohort study were to assess (i) the patients’ perceived helpfulness of different treatment modalities, (ii) the influence of sociodemographic characteristics on the patient’s perspective and (iii) whether treatment outcomes are affected by helpfulness ratings. Treatment modalities of this three-week MPMP consisted of individual physiotherapy, group-based physiotherapy, relaxation therapy, aquatic therapy, back education, medical training therapy, biofeedback, psychological pain therapy and music therapy. The study comprised 395 patients. The main outcome was the patients’ perceived treatment helpfulness at the end of the program measured by a self-reported questionnaire ranging from 1 (not at all helpful) to 6 (extremely helpful). Secondary outcomes were treatment effects on pain, pain related disability, functional ability and level of depressive symptoms measured by self-reported questionnaires (NRS, PDI, FFbH-R, ADS-L). A total of 276 patients (22–64 years, 57% female) were available for overall analysis. Multivariate-analysis-of-variance- (MANOVA-) related results revealed that perceived treatment helpfulness (range 1–6) differed significantly between treatment modalities: individual physiotherapy (M = 5.00), group-based physiotherapy (M = 4.87), relaxation therapy (M = 4.6), aquatic therapy (M = 4.54), back education (M = 4.43), medical training therapy (M = 3.38), biofeedback (M = 3.31), psychological pain therapy (M = 3.15), music therapy (M = 3.02). Pain, pain related disability and levels of depressive symptoms significantly improved after the program (p < 0.001) whereas functional ability decreased (p < 0.01). Significant correlations were found between helpfulness ratings and sociodemographic data indicating that perceived treatment helpfulness was influenced by patient-related factors. Importantly, the degree of pain-related improvements was affected by the patients’ perceived treatment helpfulness. In conclusion, patients’ perceived treatment helpfulness differs significantly between treatment modalities and corresponds to treatment outcome. View Full-Text
Keywords: multidisciplinary pain treatment; back pain; physical therapy; patient satisfaction multidisciplinary pain treatment; back pain; physical therapy; patient satisfaction
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Nees, T.A.; Riewe, E.; Waschke, D.; Schiltenwolf, M.; Neubauer, E.; Wang, H. Multidisciplinary Pain Management of Chronic Back Pain: Helpful Treatments from the Patients’ Perspective. J. Clin. Med. 2020, 9, 145.

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