Long-term effects of interprofessional biopsychosocial rehabilitation for adults with chronic non-specific low back pain : a multicentre, quasi-experimental study
Gespeichert in:
| Deutscher übersetzter Titel: | Langzeitwirkungen von einer interprofessionellen biopsychosozialen Rehabilitation bei Erwachsenen mit chronischen, unspezifischen Rückenschmerzen : eine multizentrische, quasi-experimentelle Studie |
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| Autor: | Semrau, Jana; Hentschke, Christian; Buchmann, Jana; Meng, Karin; Vogel, Heiner; Faller, Hermann; Bork, Hartmut; Pfeifer, Klaus |
| Erschienen in: | PLoS one / Public Library of Science |
| Veröffentlicht: | 10 (2015), 3, Art.-ID e0118609; [28 S.], Lit. |
| Format: | Literatur (SPOLIT) |
| Publikationstyp: | Zeitschriftenartikel |
| Medienart: | Elektronische Ressource (online) |
| Sprache: | Englisch |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0118609 |
| Schlagworte: | |
| Online Zugang: | |
| Erfassungsnummer: | PU201706004215 |
| Quelle: | BISp |
Abstract des Autors
Background
Improvement of the long-term effectiveness of multidisciplinary orthopaedic rehabilitation (MOR) in the management of chronic non-specific low back pain (CLBP) remains a central issue for health care in Germany. We developed an interprofessional and interdisciplinary, biopsychosocial rehabilitation concept named “PASTOR” to promote self-management in adults with CLBP and compared its effectiveness with the current model of MOR.
Methods
A multicentre quasi-experimental study with three measurement time points was implemented. 680 adults aged 18 to 65 with CLBP were assed for eligibil-ity in three inpatient rehabilitation centres in Germany. At first the effects of the MOR, with a total extent of 48 hours (control group), were assessed. Thereafter, PASTOR was implemented and evaluated in the same centres (intervention group). It consisted of six interprofessional modules, which were provided on 12 days in fixed groups, with a total extent of 48 hours. Participants were assessed with self-report measures at baseline, discharge, and 12 months for functional ability (primary outcome) using the Hannover Functional Ability Questionnaire (FFbH-R) and various secondary outcomes (e.g. pain, health status, physical activity, pain coping, pain-related cognitions).
Results
In total 536 participants were consecutively assigned to PASTOR (n=266) or MOR (n=270). At 12 months, complete data of 368 participants was available. The adjusted between-group difference in the FFbH-R at 12 months was 6.58 (95% CI 3.38 to 9.78) using complete data and 3.56 (95% CI 0.45 to 6.67) using available data, corresponding to significant small-to-medium effect sizes of d=0.42 (p<0.001) and d=0.10 (p=0.025) in favour of PASTOR. Further improvements in secondary outcomes were also observed in favour of PASTOR.
Conclusion
The interprofessional and interdisciplinary, biopsychosocial rehabilitation program PASTOR shows some improvements of the long-term effectiveness of inpatient rehabilitation in the management of adults with CLBP. Further insights into mechanisms of action of complex intervention programs are required.