A Controlled and Retrospective Study of 144 Chronic Low Back Pain Patients to Evaluate the Effectiveness of an Intensive Functional Restoration Program in France
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Population
2.3. Interventions
2.4. Outcome Measures
2.5. Statistical Analyses
3. Results
3.1. Pre-Treatment Characteristics
3.2. Evolution after Treatment
4. Discussion
5. Conclusions
Author Contributions
Conflicts of Interest
References
- Van Tulder, M.; Malmivaara, A.; Esmail, R.; Koes, B. Exercise therapy for low back pain: A systematic review within the framework of the cochrane collaboration back. Spine 2000, 25, 2784–2796. [Google Scholar] [CrossRef] [PubMed]
- Anderson, G.B.J. Epidemiological features of chronic low-back pain. Lancet 1999, 354, 581–585. [Google Scholar] [CrossRef]
- Waddell, G. A new clinical model for the treatment of low back. Spine 1987, 12, 165–175. [Google Scholar]
- Lewis, J.S.; Hewitt, J.S.; Billington, L.; Cole, S.; Byng, J.; Karayiannis, S. A randomized clinical trial comparing two physiotherapy interventions for chronic low back pain. Spine 2005, 30, 711–721. [Google Scholar] [CrossRef] [PubMed]
- Olivier, N.; Lepretre, A.; Caby, I.; Dupuis, M.A.; Prieur, F. Does exercise therapy for chronic lower-back pain require daily isokinetic reinforcement of the trunk muscles? Ann. Readapt. Med. Phys. 2008, 51, 284–291. [Google Scholar] [CrossRef] [PubMed]
- Stevenson, J.M.; Weber, C.L.; Smith, J.T.; Dumas, G.A.; Albert, W.J. A longitudinal study of the development of low back pain in an industrial population. Spine 2001, 26, 1370–1377. [Google Scholar] [CrossRef] [PubMed]
- Guzmán, J.; Esmail, R.; Karjalainen, K.; Malmivaara, A.; Irvin, E.; Bombardier, C. Multidisciplinary rehabilitation for chronic low back pain: Systematic review. BMJ 2001, 322, 1511–1516. [Google Scholar] [CrossRef] [PubMed]
- Maul, I.; Läubli, T.; Oliveri, M.; Krueger, H. Long-term effects of supervised physical training in secondary prevention of low back pain. Eur. Spine 2005, 14, 599–611. [Google Scholar] [CrossRef] [PubMed]
- Smeets, R.J.; Vlaeyen, J.W.; Hidding, A.; Kester, A.D.; van der Heijden, G.J.; van Geel, A.C.; Knottnerus, J.A. Active rehabilitation for chronic low back pain: Cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial. BMC Musculoskelet. Disord. 2006. [Google Scholar] [CrossRef] [PubMed]
- Verfaille, S.; Delarue, Y.; Demangeon, S.; Beuret-Blanquart, F. Evaluation after four years of exercise therapy for chronic low back pain. Ann. Readapt. Med. Phys. 2005, 48, 53–60. [Google Scholar] [CrossRef] [PubMed]
- Bontoux, L.; Roquelaure, Y.; Billabert, C.; Dubus, V.; Sancho, P.O.; Colin, D.; Brami, L.; Moisan, S.; Fanello, S.; Penneau-Fontbonne, D.; et al. Prospective study of the outcome at one year of patients with chronic low back pain in a program of intensive functional restoration and ergonomic intervention. Factors predicting their return to work. Ann. Readapt. Med. Phys. 2004, 47, 563–572. [Google Scholar] [CrossRef]
- Gagnon, S.; Lensel-Corbeil, G.; Duquesnoy, B. Multicenter multidisciplinary training program for chronic low back pain: French experience of the Renodos back pain network (Réseau Nord-Pas-de-Calais du DOS). Ann. Phys. Rehabil. Med. 2009, 52, 3–16. [Google Scholar] [CrossRef] [PubMed]
- Mayer, T.G.; Gatchel, R.J.; Kishino, N.; Keeley, J.A.; Capra, P.A.; Mayer, H.O.; Barnett, J.; Mooney, V.E. Objective assessment of spine function following industrial injury. A prospective study with comparison group and one-year follow-up. Spine 1985, 10, 482–493. [Google Scholar] [CrossRef] [PubMed]
- Mayer, T.G.; Smith, S.S.; Kondraske, G.; Gatchel, R.J.; Carmichael, T.W.; Mooney, V. Quantification of lumbar function. Part 3: Preliminary data on isokinetic torso rotation testing with myoelectric spectral analysis in normal and low-back pain subjects. Spine 1985, 10, 912–920. [Google Scholar] [CrossRef] [PubMed]
- Bendix, T.; Bendix, A.; Labriola, M.; Hæstrup, C.; Ebbehøj, N. Functional restoration versus outpatient physical training in chronic low back pain: A randomized comparative study. Spine 2000, 25, 2494–2500. [Google Scholar] [CrossRef] [PubMed]
- Frost, H.; Klaber Moffett, J.A.; Moser, J.S.; Fairbank, J.C.T. Randomised controlled trial for evaluation of fitness programme for patients with chronic low back pain. BMJ 1995, 310, 151–154. [Google Scholar] [CrossRef] [PubMed]
- Hansen, F.R.; Bendix, T.; Skov, P.; Jensen, C.V.; Kristensen, J.H.; Krohn, L.; Schioeler, H. Intensive, dynamic back-muscle exercises, conventional physiotherapy, or placebo-control treatment of low-back pain. A randomized, observer-blind trial. Spine 1993, 18, 98–108. [Google Scholar] [CrossRef] [PubMed]
- Hlobil, H.; Staal, J.B.; Twisk, J.; Köke, A.; Ariëns, G.; Smid, T.; Van Mechelen, W. The effects of a graded activity intervention for low back pain in occupational health on sick leave, functional status and pain: 12-Month results of a randomized controlled trial. J. Occup. Rehabil. 2005, 15, 569–580. [Google Scholar] [CrossRef] [PubMed]
- Hlobil, H.; Uegaki, K.; Staal, J.B.; de Bruyne, M.C.; Smid, T.; van Mechelen, W. Substantial sick-leave costs savings due to a graded activity intervention for workers with non-specific sub-acute low back pain. Eur. Spine J. 2007, 16, 919–924. [Google Scholar] [CrossRef] [PubMed]
- Jousset, N.; Fanello, S.; Bontoux, L.; Dubus, V.; Billabert, C.; Vielle, B.; Roquelaure, Y.; Penneau-Fontbonne, D.; Richard, I. Effects of functional restoration versus 3 hours per week physical therapy: A randomized controlled study. Spine 2004, 29, 487–493. [Google Scholar] [CrossRef] [PubMed]
- Keel, P.J.; Wittig, R.; Deutschmann, R.; Diethelm, U.; Knüsel, O.; Löschmann, C.; Matathia, R.; Rudolf, T.; Spring, H. Effectiveness of in-patient rehabilitation for sub-chronic and chronic low back pain by an integrative group treatment program (Swiss Multicentre Study). Scand. J. Rehabil. Med. 1998, 30, 211–219. [Google Scholar] [PubMed]
- Vanvelcenaher, J.; Voisin, P.; Struk, P.; Weissland, T.; Goethals, M.; Masse, P.; Bibré, P.; Aernoudts, E.; Raevel, D.; O’Miel, G.; et al. La restauration fonctionnelle du rachis® (RFR®) chez les lombalgiques chroniques: Bilan 1997. Ann. Phys. Rehabil. Med. 1997, 40, 444–453. [Google Scholar] [CrossRef]
- Vanvelcenaher. Restauration Fonctionnelle du Rachis Dans les Lombalgies Chroniques; Frison-Roche: Paris, France, 2003. [Google Scholar]
- Agence Nationale d’Accréditation et d’Evaluation en Santé (ANAES). Diagnostic, prise en charge et suivi des malades atteints de lombalgie chronique: Décembre 2000. Douleurs 2001, 2, 283–289. (In French) [Google Scholar]
- Van Geen, J.W.; Edelaar, M.J.; Janssen, M.; van Eijk, J.T.M. The long-term effect of multidisciplinary back training: A systematic review. Spine 2007, 32, 249–255. [Google Scholar] [CrossRef] [PubMed]
- Huskisson, E.C. Measurement of pain. Lancet 1974, 2, 1127–1131. [Google Scholar] [CrossRef]
- Price, D.D.; McGrath, P.A.; Rafii, A.; Buckingham, B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983, 7, 45–56. [Google Scholar] [CrossRef]
- Carlsson, A.M. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain 1983, 16, 87–101. [Google Scholar] [CrossRef]
- Perret, C.; Poiraudeau, S.; Fermanian, J.; Colau, M.; Benhamou, M.; Revel, M. Validity, reliability, and responsiveness of the fingertip-to-floor test. Arch. Phys. Med. Rehabil. 2001, 82, 1566–1570. [Google Scholar] [CrossRef] [PubMed]
- Byl, N.N.; Sadowsky, H.S. Intersite reliability of repeated isokinetic measurments: Cybex backsystems including trunk rotation, trunkextension-flexion, and liftask. Iso. Exerc. Sci. 1993, 3, 139–147. [Google Scholar]
- Delto, A.; Rose, S.J.; Crandell, C.E.; Strube, M.J. Reliability of isokinetic measurments of trunk muscle performance. Spine 1991, 16, 800–803. [Google Scholar] [CrossRef]
- Mayer, T.G.; Barnes, D.; Kishino, N.D.; Nichols, G.; Gatchel, R.J.; Mayer, H.; Mooney, V. Progressive isoinertial lifting evaluation. I. A standardized protocol and normative database. Spine 1988, 13, 993–997. [Google Scholar] [CrossRef] [PubMed]
- Marty, M.; Blotman, F.; Avouac, B.; Rozenberg, S.; Valat, J.P. Validation of the French version of the Dallas Pain Questionnaire in chronic low back pain patients. Rev. Rhum. Engl. 1998, 65, 126–134. [Google Scholar]
- Roche, G.; Ponthieux, A.; Parot-Shinkel, E.; Jousset, N.; Bontoux, L.; Dubus, V.; Penneau-Fontbonne, D.; Roquelaure, Y.; Legrand, E.; Colin, D.; et al. Comparison of a functional restoration program with active individual physical therapy for patients with chronic low back pain: A randomized controlled trial. Arch. Phys. Med. Rehabil. 2000, 88, 1229–1235. [Google Scholar] [CrossRef] [PubMed]
- Gatchel, R.J.; Mayer, T.G. Evidence-informed management of chronic low back pain with functional restoration. Spine 2008, 8, 65–69. [Google Scholar] [CrossRef] [PubMed]
- Haumesser, D.; Becker, P.; Grosso-Lebon, B.; Weill, G. Medical, social and economics aspects of the management of chronic low-back pain. Rev. Méd. l’Assur. Mal. 2004, 35, 27–36. [Google Scholar]
- Hazard, R.G.; Fenwick, J.W.; Kalisch, S.M.; Redmond, J.; Reeves, V.; Reid, S.; Frymoyer, J.W. Functional restoration with behavioral support. A one-year prospective study of patients with chronic low-back pain. Spine 1989, 14, 157–161. [Google Scholar] [CrossRef] [PubMed]
- Bendix, A.E.; Bendix, T.; Haestrup, C.; Busch, E. A prospective, randomized 5-year follow-up study of functional restoration in chronic low back pain patients. Eur. Spine J. 1998, 7, 111–119. [Google Scholar] [CrossRef] [PubMed]
- Bendix, A.F.; Bendix, T.; Labriola, M.; Bœkgaard, P. Functional restoration for chronic low back pain. Two-year follow-up of two randomized clinical trials. Spine 1998, 23, 717–725. [Google Scholar] [CrossRef] [PubMed]
- Casso, G.; Cachin, C.; van Melle, G.; Gerster, J.C. Return-to-work status 1 year after muscle reconditioning in chronic low back pain patients. Jt. Bone Spine 2004, 71, 136–139. [Google Scholar] [CrossRef]
- Waldburger, M.; Stucki, R.F.; Balagué, F.; Wittig, R. Early multidisciplinary approach in lumbar pain to prevent development of chronicity. Rev. Med. Suisse Romande 2001, 121, 581–584. [Google Scholar] [PubMed]
- Gatchel, R.J. The Continuing and Growing Epidemic of Chronic Low Back Pain. Healthcare 2015, 3, 838–845. [Google Scholar] [CrossRef]
- Biering-Sørensen, F. Physical measurements as risk indicators for low-back trouble over a one-year period. Spine 1984, 9, 106–119. [Google Scholar] [CrossRef] [PubMed]
- Langrana, N.A.; Lee, C.K.; Alexander, H.; Mayott, C.W. Quantitative assessment of back strength using isokinetic testing. Spine 1984, 9, 287–290. [Google Scholar] [CrossRef] [PubMed]
- Marshall, P.W.; Mannion, J.; Murphy, B.A. The eccentric, concentric strength relationship of the hamstring muscles in chronic low back pain. J. Electromyogr. Kinesiol. 2010, 20, 39–45. [Google Scholar] [CrossRef] [PubMed]
- VanDalfsen, P.J.; Syrjala, K.L. Psychological strategies in acute pain management. Crit. Care Clin. 1990, 6, 421–431. [Google Scholar] [PubMed]
- McGeary, D.D.; Mayer, T.G.; Gatchel, R.J. High pain ratings predict treatment failure in chronic occupational musculoskeletal disorders. J. Bone Jt. Surg. Am. 2006, 88, 317–325. [Google Scholar] [CrossRef] [PubMed]
- Kääpä, E.H.; Frantsi, K.; Sarna, S.; Malmivaara, A. Multidisciplinary group rehabilitation versus individual physiotherapy for chronic nonspecific low back pain: A randomized trial. Spine 2006, 31, 371–376. [Google Scholar] [CrossRef] [PubMed]
Male (n = 73) | Female (n = 71) | p | Total | |
---|---|---|---|---|
Age (yrs) | 41.3 ± 8.5 | 42.4 ± 9,2 | 0.415 | 41.9 ± 8.8 |
Mass (kg) | 84.4 ± 13 | 63.8 ± 11,1 | p < 0.001 | 74 ± 15.9 |
Height (cm) | 1.78 ± 6.8 | 1.64 ± 6.2 | p < 0.001 | 1.71 ± 0.1 |
BMI (Kg/m2) | 26.4 ± 3.8 | 23.6 ± 4 | p < 0.001 | 25 ± 4.1 |
Sick leave prior to inclusion (weeks) | 38.7 ± 38.9 | 29.6 ± 39.3 | 0.069 | 33.1 ± 39.1 |
Length of ongoing back pain (mo) | 79 ± 61 | 70 ± 61 | 0.352 | 74 ± 63 |
History of spinal surgery | 16 | 21 | 0.481 | 37 |
Smokers (cigarettes/day) | 9 ± 13 | 4 ± 7 | 0.055 | 6 ± 11 |
Leisure time Sport and physical Activity: twice or more a week | 14 | 14 | 0.059 | 21 |
Average time of inclusion in FRP (mo) | 5 ± 3 | 5 ± 4 | 0.857 | 5 ± 3 |
Pain (VAS, mm) | 49 ± 18 | 48 ± 22 | 0.546 | 49 ± 20 |
FTF distance (cm) | 18 ± 14 | 10 ± 12 | p < 0.001 | 14 ± 14 |
Male (n = 73) | Female (n = 71) | Mean | |
---|---|---|---|
BMI > 25 (%) | 55 | 37 | 46 |
History of spinal surgery (%) | 34 | 30 | 32 |
Smokers (%) | 33 | 28 | 31 |
Leisure time Sport and physical Activity: twice or more a week (%) | 19 | 20 | 19.4 |
Short Term Effects of FRP (n = 144) | Long Term Effects of FRP (n = 31) | ||||||
---|---|---|---|---|---|---|---|
Variable | T0 | T5 weeks | p value for time effect | T5 weeks | T6mo | T12mo | p value for time effect |
Pain (VAS, mm) | 50 ± 22 | 27 ± 21 | p < 0.001 | 23 ± 13 | 26 ± 22 | 25 ± 22 | 0.585 |
FTF distance (cm) | 13 ± 15 | -6 ± 8 | p < 0.001 | -6 ± 9 | -3 ± 10 | -2 ± 10 | 0.252 |
PILE (% of mass) | 25 ± 12 | 44 ± 15 | p < 0.001 | 45 ± 16 | 41 ± 14 | 39 ± 13 | 0.254 |
DPQ daily activities (%) | 75 ± 11 | 47 ± 26 | p < 0.001 | 51 ± 28 | 59 ± 30 | 56 ± 32 | 0.874 |
DPQ work and leisure (%) | 68 ± 16 | 43 ± 27 | p < 0.001 | 49 ± 29 | 59 ± 32 | 58 ± 35 | 0.798 |
DPQ anxiety and depression (%) | 46 ± 20 | 29 ± 26 | p < 0.05 | 30 ± 22 | 49 ± 27 | 50 ± 26 | 0.265 |
DPQ sociability (%) | 27 ± 18 | 28 ± 24 | 0.958 | 35 ± 25 | 39 ± 25 | 38 ± 32 | 0.968 |
Trunk strength 30° sec (ratios F/E, % of body weight) | 1.09 ± 0.28 | 0.86 ± 0.18 | p < 0.001 | 0.83 ± 0.18 | 0.83 ± 0.19 | 0.89 ± 0.26 | 0.503 |
Trunk strength 120° sec (ratios F/E, % of body weight) | 1.56 ± 1.19 | 1.07 ± 0.43 | p < 0.001 | 1.25 ± 0.62 | 1.10 ± 0.27 | 1.06 ± 0.36 | 0.926 |
Extensors Trunk strength, maximal force 30°sec (peak torque, % of body weight) | 222 ± 81 | 307 ± 89 | p < 0.001 | 318 ± 98 | 306 ± 94 | 301 ± 103 | 0.831 |
Extensors Trunk strength, endurance force 120°sec (total work, % of body weight) | 104 ± 63 | 211 ± 70 | p < 0.001 | 209 ± 89 | 186 ± 72 | 184 ± 69 | 0.182 |
Extensors Trunk strength, speed force 90°sec (power, % of mass) | 128 ± 69 | 236 ± 80 | p < 0.001 | 230 ± 87 | 219 ± 91 | 224 ± 91 | 0.898 |
Mean | |
---|---|
Return to work without facilitation (%) | 57 |
Return to work with facilitations (%) | 24 |
No return to work (%) | 19 |
Average time to return to work (days) | 30 ± 59 |
Male n = 73 | Female n = 71 | |||||||
---|---|---|---|---|---|---|---|---|
Variable | T0 | T5 weeks | p value for time effect | T0 | T5 weeks | p value for time effect | p value for Gender effect T0 | p value for Gender effect T5 |
Pain (VAS, mm) | 50 ± 19 | 25 ± 20 | p < 0.001 | 50 ± 22 | 29 ± 22 | p < 0.001 | 0.944 | 0.449 |
FTF distance (cm) | 17 ± 15 | -5 ± 8 | p < 0.001 | 9 ± 12 | -8 ± 7 | p < 0.001 | p < 0.001 | 0.140 |
PILE (% of mass) | 30 ± 13 | 52 ± 14 | p < 0.001 | 20 ± 7 | 35 ± 9 | p < 0.001 | p < 0.001 | p < 0.001 |
DPQ daily activities (%) | 75 ± 11 | 49 ± 28 | p < 0.05 | 45 ± 23 | 76 ± 12 | p < 0.001 | 0.860 | 0.520 |
DPQ work and leisure (%) | 66 ± 18 | 49 ± 29 | p< 0.05 | 70 ± 13 | 37 ± 24 | p < 0.001 | 0.526 | 0.126 |
DPQ anxiety and depression (%) | 49 ± 22 | 37 ± 31 | 0.130 | 43 ± 18 | 20 ± 18 | p < 0.001 | 0.529 | 0.056 |
DPQ sociability (%) | 24 ± 15 | 31 ± 29 | 0.368 | 31 ± 21 | 25 ± 18 | 0.511 | 0.484 | 0.389 |
Trunk strength 30° sec (ratios F/E, % of body weight) | 1.10 ± 0.30 | 0.85 ± 0.19 | p < 0.001 | 1.08 ± 0.25 | 0.88 ± 0.18 | p < 0.001 | 0.564 | 0.541 |
Trunk strength 120° sec (ratios F/E, % of body weight) | 1.77 ± 1.64 | 1.08 ± 0.45 | p < 0.001 | 1.40 ± 0.48 | 1.03 ± 0.3 | p < 0.05 | p < 0.05 | 0.709 |
Extensors Trunk strength, maximal force 30°sec (peak torque, % of body weight) | 251 ± 87 | 348 ± 96 | p < 0.001 | 195 ± 52 | 262 ± 58 | p < 0.001 | p < 0.001 | p < 0.001 |
Extensors Trunk strength, endurance force 120°sec (total work, % of body weight) | 119 ± 70 | 243 ± 75 | p < 0.001 | 91 ± 47 | 176 ± 47 | p < 0.001 | 0.053 | p < 0.001 |
Extensors Trunk strength, speed force 90°sec (power, % of mass) | 148 ± 75 | 277 ± 83 | p < 0.001 | 109 ± 43 | 190 ± 45 | p < 0.001 | p < 0.05 | p < 0.001 |
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Caby, I.; Olivier, N.; Janik, F.; Vanvelcenaher, J.; Pelayo, P. A Controlled and Retrospective Study of 144 Chronic Low Back Pain Patients to Evaluate the Effectiveness of an Intensive Functional Restoration Program in France. Healthcare 2016, 4, 23. https://doi.org/10.3390/healthcare4020023
Caby I, Olivier N, Janik F, Vanvelcenaher J, Pelayo P. A Controlled and Retrospective Study of 144 Chronic Low Back Pain Patients to Evaluate the Effectiveness of an Intensive Functional Restoration Program in France. Healthcare. 2016; 4(2):23. https://doi.org/10.3390/healthcare4020023
Chicago/Turabian StyleCaby, Isabelle, Nicolas Olivier, Frédérick Janik, Jacques Vanvelcenaher, and Patrick Pelayo. 2016. "A Controlled and Retrospective Study of 144 Chronic Low Back Pain Patients to Evaluate the Effectiveness of an Intensive Functional Restoration Program in France" Healthcare 4, no. 2: 23. https://doi.org/10.3390/healthcare4020023