Article

OBJECTIVE: To compare the effectiveness of three treatment strategies for chronic
low back pain with varying biomechanical intensity and multidisciplinary
approach. METHODS: A monocentric randomized controlled trial with a 12-months
follow-up, conducted in the French Valley Loire region from May 2009 to April
2013. Participants were working-aged patients with chronic low back pain referred
to a French chronic low back pain care-network to support medical and
occupational issues. Three treatment strategies, each for five weeks were
compared: (i) intensive and multidisciplinary program conducted in a
rehabilitation center; (ii) less intensive outpatient program conducted by a
trained private physiotherapist; (iii) mixed strategy combining the same
outpatient program associated with a weekly multidisciplinary intervention. The
effects of treatment conditions were compared using an "intention to treat"
approach: Number of days' sick leave during the 12-months following treatment,
and quality of life and social ability assessed by auto-questionnaires. RESULTS:
A total of 159 patients (58.9% men, 41.5 +/- 10.3 years old, median duration of
sick leave = 221.0 days (127.5-319.0)) were included. Sick leave duration
significantly decreased during the 12-months following treatment in the three
groups. There was no significant difference for the evolution of participants'
quality of life, social ability, and personal beliefs between the three groups.
CONCLUSION: This study confirms that disparate treatments might show similar
effectiveness because they could all work through concomitant changes in beliefs,
attitudes, and coping mechanisms. The original mixed strategy can treat a larger
number of chronic low back pain patients, at a lower cost and provide local
community-based care.

Langue : ANGLAIS