Chronic Back Pain: 'Back School Programme' improves short-term quality of life .
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(11):243 BMC Musculoskelet Disord. 2007 Feb 28;8:21.102 female patients suffering from chronic back pain were randomized to either an intervention group receiving a 'Back School Programme' in combination with medication, or to a control group only receiving medication. This study aimed to compare improvements in quality of life between groups. The results at 3 months indicated that the 'Back School Programme' intervention was successful in improving physical and mental health related measures, and could improve patients' quality of life.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sim = 1
Incerto = 0,5
Não relevante = 0
Não = 0
A Avaliação dos Critérios de Relato avalia a transparência com que os autores relatam as caraterísticas metodológicas e do ensaio na publicação. A avaliação está dividida em cinco categorias que são apresentadas de seguida.
1/4
Randomization
1/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
3/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
O Índice de Fragilidade é uma ferramenta que auxilia na interpretação de achados significativos, fornecendo uma medida de força para um resultado. O Índice de Fragilidade representa o número de eventos consecutivos que precisam de ser adicionados a um resultado dicotómico para que o resultado deixe de ser significativo. Um número pequeno representa um resultado mais fraco e um número grande representa um resultado mais forte.
Porque é que este estudo era necessário agora?
Individuals with chronic back pain experience many debilitating physical disruptions, including increased pain, decreased muscle tone and overall health, as well as psychological dysfunction, and decreased social interaction. Numerous studies have been conducted to investigate possible interventions that address back pain, one of which, is the Back School Programme. It has been suggested that this programme may reduce back pain, improve function, and expedite return to work. However, there is a paucity of evidence evaluating the efficacy of this programme. This study was needed to examine how the Back School Programme affects health related quality of life measures.
Qual era a principal questão de investigação?
Does the 'Back School Programme' intervention improve quality of life in patients suffering from chronic back pain, over a 3 month period?
- With regards to baseline data, there were no significant differences between both groups (p>0.05).
- Over the 3 month study period, the education group showed significant improvements for all subscales of the quality of life questionnaire/Short Form Health Survey (SF-36) (p<0.001).
- In the control group receiving medication, there were only significant improvements on 3 subscales: bodily pain (p=0.001), vitality (p=0.02), and mental health (p=0.04). These findings were less significant than the resulting improvements seen in the 'Back School Programme' group.
De que é que me devo lembrar mais?
Patients participating in the 'Back School Programme' enjoyed significantly greater improvements in quality of life measures (all 8 SF-36 subscales) compared to those only receiving medication.
Como é que isto afectará o tratamento dos meus doentes?
Th results of this study indicated that both physical functioning, as well as mental health can be significantly improved with the 'Back School Programme' in patients with chronic low back pain. Further studies are needed to examine the long-term effects and to further investigate the efficacy of this education programme.
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