Improved outcomes with active, cognitive-behavioural, or combined treatment for LBP .
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(12):206 BMC Musculoskelet Disord. 2006 Jan 20;7:5227 patients with chronic non-specific low back pain (LBP) were randomized to undergo an active rehabilitation program focused on active physical treatment, cognitive-behavioural treatment, a combination of both, or placed on a waiting list (control group). The primary outcome were subjective variables in pain and function. Results indicated that the two intervention treatments and the combined treatment were effective compared to the control group. No significant clinical differences were seen between the individual interventions and the combination group.
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)?
Oui = 1
Incertain = 0,5
Non pertinent = 0
Non = 0
L'évaluation des critères de rapport permet d'évaluer la transparence avec laquelle les auteurs rapportent les caractéristiques méthodologiques et les caractéristiques de l'essai dans la publication. L'évaluation est divisée en cinq catégories qui sont présentées ci-dessous.
4/4
Randomization
3/4
Outcome Measurements
2/4
Inclusion / Exclusion
4/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
L'indice de fragilité est un outil qui aide à l'interprétation des résultats significatifs, en fournissant une mesure de la force d'un résultat. L'indice de fragilité représente le nombre d'événements consécutifs qui doivent être ajoutés à un résultat dichotomique pour que le résultat ne soit plus significatif. Un petit nombre représente un résultat plus faible et un grand nombre un résultat plus fort.
Pourquoi cette étude était-elle nécessaire maintenant ?
Low back pain (LBP) is often treated based on three different models: the physical deconditioning model, the cognitive behavioural model and the biopsychosocial model. However, there is a lack of information between what type of treatment is most effective. This study examines the outcomes of treating patients with chronic LBP using physical active rehabilitation, cognitive-behavioural active rehabilitation, a combination of both, or none.
Quelle était la principale question de recherche ?
What are the outcomes in pain and function when cognitive-behavioural active rehabilitation, physical active rehabilitation, a combination of both, or no treatment is administered in patients with chronic non-specific low back pain examined immediately post-intervention?
- All 3 intervention treatments resulted in significant reductions in functional limitations, patient's main complaints, and pain intensity compared to the waiting list control group.
- The 3 intervention treatment groups reported higher ratings in the outcomes of self-rated treatment effectiveness and satisfaction.
- No clinically relevant differences were found between the CT and APT groups, or between CT and CBT groups.
- APT and CT showed improvements in a number of physical performance tasks, while the CBT group did not.
De quoi dois-je me souvenir en priorité ?
The 3 intervention treatments (active physical treatment, cognitive-behavioural treatment, and combined treatment) demonstrated better outcomes when compared to the waiting list control group. No clinically significant differences were seen when the combined intervention treatments were compared to the individual intervention treatements.
Comment cela affectera-t-il les soins prodigués à mes patients ?
Undergoing active physical treatment, cognitive-behavioural treatment, or a combined treatment of both may provided improvements in functional limitations and pain intensity for patients suffering from chronic non-specific low back pain.
AVIS DE NON-RESPONSABILITÉ
Le contenu de cette page est fourni à titre d'information uniquement et n'est pas destiné à remplacer un avis médical, un diagnostic ou un traitement professionnel. Si vous avez besoin d'un traitement médical, demandez toujours l'avis de votre médecin ou rendez-vous au service des urgences le plus proche. Les opinions, croyances et points de vue exprimés par les individus sur le contenu de cette page ne reflètent pas les opinions, croyances et points de vue d'OrthoEvidence.
0 de 4 articles mensuels GRATUITS débloqués
