Abstract
Objective: Assess outcomes following a three-month multi-disciplinary spinal rehabilitation program for chronic low back pain, based in the community in a £10 million sports centre.
Design: This was a prospective study with data being collected before and at the completion of the programme. The programme team consists of an orthopaedic surgeon, physiotherapists, fitness instructor, nurse counsellor and a secretary. The programme included a graded aerobic fitness programme, spinal stabilisation programme, cognitive behavioural therapy, hydrotherapy and occupational therapy.
Subjects: 112 patients with chronic mechanical back pain. Mean duration of symptoms 9.1 years. Mean age was 46 years: 52 women and 60 men.
Outcome Measures: Included visual analogue score, Oswestry Disability Score (OSW), lumbar motion velocity, shuttle walking test, lifting endurance, isometric strength of spinal extension and flexion and the return to work rate.
Results: Mean VAS back pain and leg pain scores reduced from 6.6 to 4.1 and 3.7 to 2.2 respectively (p< 0.001). Mean OSW decreased from 34.6% to 21.7% (p< 0.001). Back pain improved by 37% and the Oswestry score by 42%. Only three of the 112 patients went on to have surgery. Mean lumbar motion velocity improved from 114 to 161 degrees/second (P< 0.001). Shuttle walking test improved from 458 to 644 metres (p< 0.001). Mean lifting maximum improved from 16.1 to 19.3Kg (p=0.005). Lifting endurance improved from 51 to 38 seconds. Mean Isometric spinal extensor strength improved from 24.2Kg to 48.6Kg and flexion from 25.7 to 49.4Kg (p< 0.001 in all cases). Thirty-eight percent of patients were unemployed before the program and 10% after the program. Patients also reported needing less analgesia, having more confidence, feeling happier and their flare-ups settling more quickly.
Conclusions: This three-month programme delivered significant improvements in back pain, disability, strength and endurance capacity and a return to work rate, in this cohort of chronic back pain patients.
Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK
BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.
