Effectiveness of a Group-Based Rehabilitation Program Combining Education with Multimodal Exercises in the Treatment of Patients with Nonspecific Chronic Low Back Pain: A Retrospective Uncontrolled Study.

Abstract

Simple SummaryLow back pain is a major and worldwide cause of global disability. It is not rare that an acute episode of low back pain evolves towards a chronic status without any specific cause. While many clinicians focus their treatment on low-value -care interventions (e.g., massage or electrotherapy), best clinical practice guidelines now recommend a mixed approach combining exercises and education. Furthermore, owing to the potential advantages that confer patient interactions with others (support, motivation, and program compliance), we decided to launch such an intervention program in a group setting (MyBack program) and aimed to evaluate its effectiveness through this study. Following this 8-week intervention program, approximately three-quarters of the patients reported a relevant reduction in pain intensity (78%), catastrophic thinking (78%), functional disability (74%), and fear of movement and work-related activities (74%). Only a quarter of the patients (26%) reported a relevant improvement in quality of life, probably because this outcome was already high before treatment. The MyBack program combining education with multimodal group exercises led to satisfactory clinical, functional, and psychosocial outcomes.Currently, there is no consensus on the best rehabilitation program to perform for nonspecific chronic low back pain (NSCLBP). However, multimodal exercises, education, and group-based sessions seem to be beneficial. We, therefore, launched such a treatment program and aimed to evaluate its effectiveness in improving patient health status. We retrospectively analyzed the records of 23 NSCLB patients who followed the MyBack program at La Tour hospital from 2020 to 2022 (25 sessions, 8 weeks). Patients were evaluated before and after intervention using pain on a visual analog scale (pVAS), Roland–Morris Disability Questionnaire (RMDQ), Pain Catastrophizing Scale (PCS), Tampa Scale of Kinesiophobia (TSK), and the EuroQol-5D-3L (EQ-5D-3L). Responder rates were calculated using minimal clinically important differences. Patients reported a significant reduction (p < 0.05) in the pVAS (5.3 ± 1.2 vs. 3.1 ± 1.6), RMDQ (8.8 ± 3.3 vs. 4.0 ± 3.7), PCS (24.5 ± 9.4 vs. 11.7 ± 7.9) and TSK (41.5 ± 9.2 vs. 32.7 ± 7.0). The EQ-5D-3L also statistically improved (score: 0.59 ± 0.14 vs. 0.73 ± 0.07; and VAS: 54.8 ± 16.8 vs. 67.0 ± 15.2). The responder rates were 78% for the pVAS and PCS, 74% for the RMDQ and TSK, and only 26% for the EQ-5D-3L. The MyBack program combining education with multimodal group exercises led to satisfactory clinical, functional, and psychosocial outcomes.