Outcomes of physical therapy in patients with chronic low back pain

Zalica Klemenc Ketiš
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Abstract

Purpose: To assess the outcomes of a10–treatment sessions program of physical therapy regarding the level of pain and health–related quality of life in patients with chronic, non–specific, low back pain.Methods: A consecutive sample of adults (N = 129) with chronic, non–specific, low back pain was assessed for improvement after a 10–day physical therapy program, consisting of an average of 3 different physical modalities, as prescribed by family physicians. A visual analog pain scale and EuroQol questionnaire (EQ–5D and EQ–VAS) were completed by patients before and after physical therapy.Results: The intensity of pain after 10 days of physical therapy was on average lower (1.7 ± 1.8 points; P < 0.001). The assessment of overall health on the EQ–VAS was on average better (10.3 ± 15.2 points; P < 0.001). The score of the EQ–5D was on average lower (0.8 ± 1.2 points; P < 0.001). The patients that were not on sick leave during the physical therapy reported a greater lowering of the intensity of pain than those on sick leave (P = 0.03). Patients with a BMI > 29 kg/m2 had a significantly higher change in the assessment of overall health on the EQ–VAS (P = 0.022). The patients that had group exercise in the set of procedures reported a greater improvement in overall health on the EQ–VAS compared to the patients that didnot have group exercise (P = 0.036). The patients with anxiety and depression had a significantly higher change in the composite score of the EQ–5D (P = 0.013). Patients with a BMI > 29 kg/m2 had a significantly higher change in the composite score of the EQ–5D (P = 0.013).Conclusion: Physical therapy has some effect in the short–term treatment of patients with chronic, non–specific, low back pain, but the viability of such procedures in this population of patients is questionable.
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慢性腰痛患者物理治疗的结果
目的:评估慢性、非特异性腰痛患者的疼痛水平和健康相关生活质量的10个疗程物理治疗方案的结果。方法:对患有慢性、非特异性腰痛的成人(N = 129)进行连续抽样,评估他们在接受由家庭医生规定的平均3种不同的物理治疗方案后10天的改善情况。患者在物理治疗前后分别完成视觉模拟疼痛量表和EuroQol问卷(EQ-5D和EQ-VAS)。结果:物理治疗10 d后疼痛强度平均降低(1.7±1.8分);P < 0.001)。EQ-VAS总体健康评分平均较好(10.3±15.2分;P < 0.001)。EQ-5D得分平均较低(0.8±1.2分);P < 0.001)。物理治疗期间未请病假的患者疼痛强度比请病假的患者明显降低(P = 0.03)。BMI > 29 kg/m2的患者在EQ-VAS上的整体健康评估变化显著更高(P = 0.022)。在一组程序中进行小组锻炼的患者与没有进行小组锻炼的患者相比,在EQ-VAS上报告了更大的整体健康改善(P = 0.036)。焦虑、抑郁患者的EQ-5D综合评分变化显著高于焦虑、抑郁患者(P = 0.013)。BMI > 29 kg/m2的患者EQ-5D综合评分变化显著高于BMI > 29 kg/m2的患者(P = 0.013)。结论:物理疗法在慢性非特异性腰痛患者的短期治疗中有一定效果,但这种治疗方法在这类患者中的可行性值得怀疑。
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