Active or passive - Which therapy do patients with chronic low-back pain prefer?

Purpose: From medical view, active therapy and selfmanagement is very important for patients with chronic Low-Back Pain (cLBP) in the framework of multi-modal therapy. The aim of our investigation was to examine the patient's viewpoint in this respect. Materials and Methods: A cross-sectional design has been used. The sample consisted of 101 stationary rehabilitants with cLBP (mean age: 49 years; SD: 9.8 years; min./max.: 22/62 years; 19% female). Three weeks before rehabilitation started, patients had been asked for their attitude towards active/passive therapy and selfmanagement. Question 1: Two different types of therapy can be distiguished: active (exercise therapy, medical training therapy, ...) and passive (massages, mud baths, ...). Which type is the best one to improve your complaints in your opinion? For the patients the following answers have been available: ,,only passive ones", ,,rather passive ones",,both of them", ,,rather active ones", ,,only active ones". Question 2: How much can you contribute by your behaviour to improve your complaints? Question 3: How much can the therapies in the rehabilitation centre contribute to improve your complaints? Answers available for question 2 and 3: ,,nothing", ,, little",,middle-rate", ,, a lot", ,,great many". Results: Responded to question 1, a minority of patients (15%) qualified,rather" or ,,only" active therapy as being able to improve their complaints. With regard to question 2, a minority of 4% replied that they could do ,,nothing" or little" to ameliorate their pain by their behaviour and concerning question 3, 15% stated that the therapies of the rehabilitation centre could contribute ,,nothing" or ,,less" to improve their medical condition. Conclusion: The three questions offer a good possibility to find out patients who seem to disagree with active multimodal, therapy, whose outcome could therefore be challenged from the outset. If these questions are asked before starting rehabilitation, as was done here, countermeasures could be taken. Causes for their negative attitudes should be found out. These findings should receive attention when the patient is informed about his medical condition and the different types of therapy as well as the attempt to motivate the patient for more sportive activity and selfmanagement, in order to ensure lasting effects.