Article

Objective: To evaluate the health-related quality of life effects of muscle
stretching, manual therapy and steroid injections in addition to 'stay active'
care in acute or subacute low back pain patients.
Study design: A randomized,
controlled trial during 10 weeks with four treatment groups. Setting: Nine primary health care and one outpatient orthopaedic hospital department. Subjects:
One hundred and sixty patients with acute or subacute low back pain.
Interventions: Ten weeks of 'stay active' care only (group 1), or 'stay active'
and muscle stretching (group 2), or 'stay active', muscle stretching and manual
therapy (group 3), or 'stay active', muscle stretching, manual therapy and
steroid injections (group 4). Main measures: The Gothenburg Quality of Life
instrument subscales Well-being score and Complaint score. Results: In a
multivariate analysis adjusted for possible outcome affecting variables other
than the treatment given Well-being score was 68.4 (12.5), 72.1 (12.4), 72,3
(12.4) and 72.7 (12.5) in groups 1-4, respectively (P for trend <0.05). There
were significant trends for the well-being components patience (P < 0.005),
energy (P < 0.05), mood (P < 0.05) and family situation (P < 0.05). The remaining
two components and Complaint score showed a non-significant trend towards
improvement. Conclusion:
The effects on health-related quality of life were
greater the larger the number of treatment modalities available. The 'stay
active' treatment group, with the most restricted number of modalities, had the
most modest health-related quality of life improvement, while group 4 with the
most generous choice of treatment modalities, had the greatest improvement.

Langue : ANGLAIS