Individualised physiotherapy for low back pain
The following study investigated whether individualised physiotherapy plus guideline-based evidence resulted in superior outcomes to advice alone in participants with low-back disorders.
The results demonstrated that physiotherapy individualised to pathoanatomical, psychosocial and neurophysiological barriers and incorporating advice was more effective than two sessions of advice alone in participants with low-back disorders.
Many patients with low back disorders (LBD) persisting beyond six weeks do not recover. The following randomised controlled trial tested the hypothesis that individualised physiotherapy (IP) combined with guideline-based advice (IPA) will result in larger improvements in activity, back pain and leg pain than advice alone.
156 participants with six weeks to six months of low-back pain were randomised to undergo 10 sessions of individualised physiotherapy sessions, while a further 144 participants received two sessions of physiotherapy-delivered advice alone.
The results demonstrated that ten sessions of physiotherapy individualised to pathoanatomical, psychosocial and neurophysiological barriers and incorporating guideline-based advice was more effective than two sessions of advice alone in participants with low-back disorders of ≥6 weeks and ≤6 months duration. The additional benefits of individualised physiotherapy were sustained at 12 months for activity limitation and 6 months for back and leg pain.
Further research is required to confirm cost-effectiveness, specific verses non-specific effects, as well as effectiveness in different populations and against other comparison treatments. For participants with a LBD not recovering after 6 weeks, 10 sessions of IPA is likely to offer better outcomes than 2 sessions of guideline-based advice.
> From: Ford et al., Br J Sports Med (2015) (Epub ahead of print). All rights reserved to BMJ Publishing Group Ltd. Click here for the Pubmed summary.