Measuring quality of life changes in individuals with chronic low back conditions: a back education program evaluation

This study examined the effectiveness of an interdisciplinary back evaluation and education program in improving patient health-related quality of life utilizing the SF-36 physical and mental component summary scores as dependent variables. It used repeated measures analysis of covariance (ANCOVA) in a pre-post design to examine a back program group of patients (N = 92) over a period of one year. This was compared to an ANCOVA pre-post design examining a physician clinic group of back patients (N = 61) over one year. Control variables for each group included age, gender, payor, major depression risk, back pain level, disability scale, and whether surgery occurred. Because of selection bias, the two groups could not be compared, although a qualitative comparison suggests that the back program group had an effect independent of physician visits and time. The back education program was probably effective in improving patients' physical quality of life. Diminished disability, being male, having had surgery during treatment, not receiving workers' compensation, and not being at risk for major depression at baseline helped improve physical component summary scores. Treatment had no effect on mental component summary scores. The comparison group, which received no treatment, did not statistically improve in either the physical or mental component/domain. (C) 2002 Elsevier Science Ltd. All rights reserved.