Efficacy and treatment compliance of a home-based rehabilitation programme for chronic low back pain: a randomized, controlled study

Abstract

Objective: To assess the efficacy and treatment compliance of a home-based rehabilitation programme for chronic low back pain (CLBP).

Population: CLBP outpatients treated in a Physical Medicine Rehabilitation or Rheumatology unit within a university hospital.

Methods: We performed a prospective, comparative study. The participants were randomly assigned to either a home-based rehabilitation programme (Gp A) or a standard physical therapy (Gp B). The programme included four weekly sessions. In each group, we measured pain intensity (on a visual analogue scale, VAS), flexibility and muscle endurance (the Schöber MacRae test, finger-to-floor distance, thigh-leg angle, the Shirado and Sorensen test), functional and psychological repercussions (the Quebec functional index and the Hospital Anxiety and Depression scale) and handicap (on a VAS). Follow-up examinations took place at baseline and four weeks and three, six and 12 months later.

Results: One hundred and seven patients (82 women) with a mean+/-standard deviation (S.D.) age of 35.7+/-0.8 years were included (with 54 patients in Gp A). At four weeks, a significant improvement (relative to baseline) was observed for all parameters in both study groups but with a significantly greater difference in Gp A, which was maintained at one year (despite an observed regression of the improvement at six months). At one year, compliance with the home-based rehabilitation programme was good (68.1%) and 59.5% of the patients regarded the programme as useful.

Conclusion: Our results suggest that a home-based rehabilitation programme is as effective as standard physical therapy. However, this type of programme requires patient motivation and regular follow-up.