Abstract
Background:
Combined physical and psychological (CPP) programmes are widely recommended for Chronic Low Back Pain (CLBP) patients. Patients with longstanding CLBP participating in a two-week CPP-programme improve in functional status and quality of life and the results are maintained for at least one year. First indications of maintenance of improved patient-reported outcomes are shown at two-year follow-up assessment.
Purpose:
Evaluation of the long-term (at least five years of follow up) maintenance of positive results of a short, intensive, evidence based CPP-programme.
Methods and Results:
A consecutive cohort study was performed, with a mean follow up of 6.5 years (range: 5.5–7.5). At follow up a response rate of 85% (n=277) was achieved. At pre-treatment the mean age was 46.1years (SD9.3) and the mean CLBP-duration 12.3years (SD10.9). Primary outcome was functional status (Oswestry Disability Index [ODI;0-100]). Secondary outcomes: pain intensity, quality of life, and satisfaction. A Repeated Measures analysis of variance was used to identify changes over time. The mean ODI-score showed improvement at post-treatment and maintenance of results over time (ODI df[1,276], F = 0.146, p = 0.703). Secondary outcomes showed the same pattern. At long-term follow up almost half of the CLBP-patients (45.3%) reached a functional status equivalent to an acceptable, normal healthy population value (ODI≤22), comparable to the 1-year follow-up assessment. 80.1% of the participants are satisfied with treatment results and 76.2% would recommend the programme to family/friends.
Conclusion:
Long-term effectiveness of a CPP-programme is demonstrated. Patients improve during the programme and 1-year follow-up results are maintained after 6.5 years follow up.
