A retrospective audit of the ‘Back in Motion Programme': A stratified group based, physiotherapy programme for patients with Chronic Low Back Pain

Abstract

Background: Low back pain (LBP) is one of the leading causes of disability worldwide with an estimated 632 million people affected. With LBP linked with a huge financial and societal burden much research has focused on developing the best treatment approach for this patient population. Recent research would present that by stratifying patients, utilising the Keele ‘STarT Back’ tool, into more homogeneous groups and providing them with targeted treatment that results achievable are more clinically cost effective. More recently, research by an Irish physiotherapist has suggested that if this stratified care approach is employed in a group setting, favourable results are also observed, specifically in patients with LBP. Objectives: To determine the efficacy of the physiotherapy lead ‘Back in Motion Programme’: a stratified group exercise/education intervention, aimed at managing a cohort of patients with chronic LBP, run in an Irish Teaching Hospital. Method: A retrospective audit of the chronic LBP patients who were referred into the ‘Back in Motion Programme’ was completed from June-August 2016. Two hundred and thirty-eight charts were audited of patients who were referred into the programme between January 2015 and June 2016. Details on what happened patients upon referral into the programme was gathered. Patient profiles including age, gender, LBP duration, waiting time to be seen by physiotherapy and referral source were recorded. Initial and final outcome measure scores were recorded (Rowland Morris Disability Questionnaire, Keele STarT back tool and Brief Pain inventory). Patient class attendance records were also noted. Information on patient follow up care, if any, on programme completion was also recorded. Results: Two hundred and thirty-eight patients were referred into the ‘Back in Motion Programme’, of this 37 (15.4%) patients completed the programme in full. Improvements in all three patient outcome measures were observed to be of statistical significant. The greatest improvements were observed in the Rowland Morris Disability Questionnaire (p= 0.000198). The average change in Rowland Morris Disability Questionnaire was 3 units, a score greater or equal to the MDC of 2-3 units for this outcome measure. Conclusions: The ‘Back in Motion Programme’ was seen wo be effective in the management of patients with chronic LBP who completed the programme in full. Despite the large patient non-attendance numbers these finding have implications for future rehabilitation programmes for this patient population.