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

Ann Phys Rehabil Med. 2009 Jul;52(6):485-96. doi: 10.1016/j.rehab.2009.04.002. Epub 2009 May 15.
[Article in English, French]

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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Chronic Disease
  • Exercise Therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Low Back Pain / rehabilitation*
  • Male
  • Middle Aged
  • Muscle Stretching Exercises
  • Outpatients
  • Pain Measurement
  • Patient Compliance
  • Patient Satisfaction
  • Physical Endurance
  • Physical Therapy Modalities
  • Range of Motion, Articular
  • Self Care
  • Severity of Illness Index
  • Young Adult