One-year follow-up comparison of the effectiveness of McKenzie treatment and strengthening training for patients with chronic low back pain - Outcome and prognostic factors

被引:44
作者
Petersen, Tom [1 ]
Larsen, Kristian [2 ]
Jacobsen, Soren [3 ]
机构
[1] Back Ctr Copenhagen, DK-2100 Copenhagen, Denmark
[2] Holstebro Hosp, Holstebro, Denmark
[3] Copenhagen Univ Hosp, Dept Rheumatol, Rigshospitalet, Denmark
关键词
randomized controlled trial; prognosis; explanatory value; chronic disease; low back pain; outcome; exercise therapy; exercises;
D O I
10.1097/BRS.0b013e31815cda4a
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. A randomized controlled trial with multivariable analyses of prognostic factors. Objective. To. report the long-term outcome of McKenzie treatment compared with strengthening training. Further, to determine patient-related factors associated With poor outcome 14 months after completion of treatment. Summary of Background Data. Exercise therapy is widely recommended for patients with chronic low back pain. However, reports vary considerably concerning characteristics of patients who will not respond to treatment. Knowledge of factors associated with poor outcome may assist identification of patients requiring special attention. Methods. A total of 260 patients with chronic low back pain were included in a previously reported randomized controlled trial of McKenzie therapy versus strengthening training. Outcome variables were: functional status, pain level, work status, and use of healthcare services during follow-up. Also, factors associated with withdrawal during the intervention were sought identified. The following factors of possible prognostic significance were determined: levels of pain and disability, pain-distribution, duration of symptoms, smoking habits, leisure activities, workload, job satisfaction, treatment preference, outcome expectations, treatment modality received, compliance with home exercises during follow-up, and demographic variables such as age, gender,work status, and application for pension. Association between variables was examined by multiple logistic regression analysis and odds ratios. Results. No differences in outcomes were found between the treatment groups at 14 months of follow-up. Low level of pain intensity and disability, sick leave at entry, low pretreatment expectations of future work ability, withdrawal during treatment, and discontinuance of exercises after the end of the treatment period were associated with poor outcome. Conclusion. Poor long-term outcome of exercise therapy for chronic low back pain can be explained by a number of patient-related factors. Different prognostic factors were associated with different outcomes. These factors were more important in determining outcome than the exercise-programs studied.
引用
收藏
页码:2948 / 2956
页数:9
相关论文
共 53 条
[1]  
Albright J, 2001, PHYS THER, V81, P1629
[2]  
Altman DG., 1990, PRACTICAL STAT MED R
[3]  
[Anonymous], 2003, Screening to Identify People at Risk of Long-term Incapacity for Work
[4]   PSYCHOSOCIOECONOMIC PREDICTORS OF TREATMENT SUCCESS FAILURE IN CHRONIC LOW-BACK-PAIN PATIENTS [J].
BARNES, D ;
SMITH, D ;
GATCHEL, RJ ;
MAYER, TG .
SPINE, 1989, 14 (04) :427-430
[5]   MANAGING LOW-BACK-PAIN - ATTITUDES AND TREATMENT PREFERENCES OF PHYSICAL-THERAPISTS [J].
BATTIE, MC ;
CHERKIN, DC ;
DUNN, R ;
CIOL, MA ;
WHEELER, KJ .
PHYSICAL THERAPY, 1994, 74 (03) :219-226
[6]   Sociodemographic predictors of treatment outcome in chronic non-malignant pain patients. Do patients receiving or applying for Disability Pension benefit from multidisciplinary pain treatment? [J].
Becker, N ;
Hojsted, J ;
Sjogren, P ;
Eriksen, J .
PAIN, 1998, 77 (03) :279-287
[7]   Factors related to successful work hardening outcomes [J].
Beissner, KL ;
Saunders, RL ;
McManis, BG .
PHYSICAL THERAPY, 1996, 76 (11) :1188-1201
[8]   Can it be predicted which patients with chronic low back pain should be offered tertiary rehabilitation in a functional restoration program?: A search for demographic, socioeconomic, and physical predictors [J].
Bendix, AF ;
Bendix, T ;
Hæstrup, C .
SPINE, 1998, 23 (16) :1775-1783
[9]   Functional restoration versus outpatient physical training in chronic low back pain -: A randomized comparative study [J].
Bendix, T ;
Bendix, A ;
Labriola, M ;
Hæstrup, C ;
Ebbehoj, N .
SPINE, 2000, 25 (19) :2494-2500
[10]   The effect of dynamic strength back exercise and/or a home training program in 57-year-old women with chronic low back pain - Results of a prospective randomized study with a 3-year follow-up period [J].
Bentsen, H ;
Lindgarde, F ;
Manthorpe, R .
SPINE, 1997, 22 (13) :1494-1500