Service evaluation of patient outcomes at Defence Medical Rehabilitation Centre Stanford Hall following multidisciplinary rehabilitation for persistent low back pain

Physiotherapy ◽  
2021 ◽  
Vol 113 ◽  
pp. e99-e100
Author(s):  
T. Zimbwa
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Patient Outcomes ◽  
Service Evaluation ◽  
Medical Rehabilitation ◽  
Low Back ◽  
Rehabilitation Centre ◽  
Multidisciplinary Rehabilitation

Cognitive functional therapy (CFT)-based rehabilitation improves clinical outcomes in UK military personnel with persistent low back pain

2019 ◽  
Vol 166 (5) ◽  
pp. 336-341 ◽  
Author(s):  
Dean Conway ◽  
P Ladlow ◽  
J Ferreira ◽  
S Mani-Babu ◽  
A N Bennett
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Psychosocial Outcomes ◽  
Medical Rehabilitation ◽  
Low Back ◽  
Functional Therapy ◽  
Multidisciplinary Rehabilitation ◽  
British Military ◽  
Patient Reported

IntroductionLow back pain (LBP) has been reported as the most common reason for presentation to the Medical Centre in the British Military, and the most common re-referral for the same condition. In 2015, the UK Defence Medical Rehabilitation Centre (DMRC) adopted a cognitive functional therapy (CFT) approach to spinal rehabilitation in line with National Institute for Health and Care Excellence and military best practice guidelines. The aim of this study is to evaluate the functional and psychosocial outcomes of all patients with chronic LBP treated with CFT-based multidisciplinary rehabilitation at DMRC, Headley Court.MethodsA prospective observational service evaluation of British Military patients (n=238) with LBP who attended 3 weeks of inpatient multidisciplinary CFT-based programme from 2015 to the end of 2017 at DMRC was analysed. Functional outcomes include: multistage locomotion test (MSLT) and sit and reach test. Psychosocial outcomes include: Tampa Scale of Kinesiophobia, Oswestry Disability Index, Brief Pain Inventory (BPI), General Anxiety Disorder-7 and Patient Health Questionnaire-9.ResultsThere were significant improvements in endurance (MSLT), range of motion, kinesiophobia, pain-related lifestyle interference (BPI-Lifestyle), anxiety and depression (p≤0.001). However, no improvements in pain intensity (BPI-Intensity) were demonstrated (p>0.05).ConclusionAfter 3 weeks of CFT-based multidisciplinary rehabilitation, function and psychosocial health improved with symptoms of pain being less obtrusive to activities of daily activity. There were however no patient-reported reductions in pain intensity. The improvements demonstrated are indicative of outcomes that facilitate greater integration back to work or into society.

Low back pain in pregnancy and post-partum period. Principles for medical rehabilitation

2018 ◽  
Vol 1 (19) ◽  
pp. 22
Author(s):  
Iulia Filipescu ◽  
Mihai Berteanu ◽  
George Alexandru Filipescu ◽  
Radu Vlădăreanu
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Post Partum ◽  
Medical Rehabilitation ◽  
Low Back ◽  
Post Partum Period ◽  
In Pregnancy

scholarly journals Implementation of Clinical Guidelines on Physical Therapy for Patients With Low Back Pain: Randomized Trial Comparing Patient Outcomes After a Standard and Active Implementation Strategy

2005 ◽  
Vol 85 (6) ◽  
pp. 544-555 ◽  
Author(s):  
Geertruida E Bekkering ◽  
Maurits W van Tulder ◽  
Erik JM Hendriks ◽  
Marc A Koopmanschap ◽  
Dirk L Knol ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Patient Outcomes ◽  
Physical Functioning ◽  
Clinical Guidelines ◽  
Physical Therapists ◽  
Low Back ◽  
Active Strategy ◽  
Active Implementation

Abstract Background and Purpose. An active strategy was developed for the implementation of the clinical guidelines on physical therapy for patients with low back pain. The effect of this strategy on patients' physical functioning, coping strategy, and beliefs regarding their low back pain was studied. Subjects. One hundred thirteen primary care physical therapists treated a total of 500 patients. Methods. The physical therapists were randomly assigned to 1 of 2 groups. The control group received the guidelines by mail (standard passive method of dissemination). The intervention group, in contrast, received an additional active training strategy consisting of 2 sessions with education, group discussion, role playing, feedback, and reminders. Patients with low back pain, treated by the participating therapists, completed questionnaires on physical functioning, pain, sick leave, coping, and beliefs. Results. Physical functioning and pain in the 2 groups improved substantially in the first 12 weeks. Multilevel longitudinal analysis showed no differences between the 2 groups on any outcome measure during follow-up. Discussion and Conclusion. The authors found no additional benefit to applying an active strategy to implement the physical therapy guidelines for patients with low back pain. Active implementation strategies are not recommended if patient outcomes are to be improved.

scholarly journals Analysis of State Insurance Coverage for Nonpharmacologic Treatment of Low Back Pain as Recommended by the American College of Physicians Guidelines

2019 ◽  
Vol 8 ◽  
pp. 216495611985562 ◽  
Author(s):  
Robert Bonakdar ◽  
Dania Palanker ◽  
Megan M Sweeney
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Spinal Manipulation ◽  
Tai Chi ◽  
Insurance Coverage ◽  
Low Back ◽  
Chronic Pain Management ◽  
Multidisciplinary Rehabilitation ◽  
Nonpharmacologic Treatment

Background In 2017, the American College of Physicians (ACP) released guidelines encouraging nonpharmacologic treatment of chronic low back pain (LBP). These guidelines recommended utilization of treatments including multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction (MBSR), tai chi, yoga, progressive relaxation, biofeedback, cognitive behavioral therapy (CBT), and spinal manipulation. Objective We aimed to determine status of insurance coverage status for multiple nonpharmacological pain therapies based on the 2017 Essential Health Benefits (EHB) benchmark plans across all states. Methods The 2017 EHB benchmark plans represent the minimum benefits required in all new policies in the individual and small group health insurance markets and were reviewed for coverage of treatments for LBP recommended by the ACP guidelines. Additionally, plans were reviewed for limitations and exclusionary criteria. Results In nearly all state-based coverage policies, chronic pain management and multidisciplinary rehabilitation were not addressed. Coverage was most extensive (supported by 46 states) for spinal manipulation. Acupuncture, massage, and biofeedback were each covered by fewer than 10 states, while MBSR, tai chi, and yoga were not covered by any states. Behavioral health treatment (CBT and biofeedback) coverage was often covered solely for mental health diagnoses, although excluded for treating LBP. Conclusion Other than spinal manipulation, evidence-based, nonpharmacological therapies recommended by the 2017 ACP guidelines were routinely excluded from EHB benchmark plans. Insurance coverage discourages multidisciplinary rehabilitation for chronic pain management by providing ambiguous guidelines, restricting ongoing treatments, and excluding behavioral or complementary therapy despite a cohesive evidence base. Better EHB plan coverage of nondrug therapies may be a strategy to mitigate the opioid crisis. Recommendations that reflect current research-based findings are provided to update chronic pain policy statements.

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