Effectiveness of in-patient rehabilitation for sub-chronic and chronic low back pain by an integrative group treatment program (Swiss Multicentre Study)

Abstract

In this multicentre intervention study, we compared an integrated group treatment program which combines psychological and education methods into a more active training approach, with the traditional individual approach of physiotherapy and physical procedures for sub-chronic and chronic low back pain. Our 411 patients had a 4-week inpatient treatment: 243 patients in an experimental program and 168 in a traditional program. Outcomes of 283 patients were assessed 3 months and 1 year after entry. The dropout rate was 31.1%. Both conditions demonstrated favourable initial effects on functional and psychological parameters, but the integrated approach showed better long-term results for work rehabilitation than the traditional approach. The most successful patients (n = 58) were younger and had a higher educational level in comparison to the unsuccessful subgroup (n = 71). The main conclusion is that an integrated approach promoting self control and behaviour change through educational measures achieves better long-term results than the traditional individual physiotherapy approach.