Format

Send to

Choose Destination
Phys Ther. 2015 Mar;95(3):319-36. doi: 10.2522/ptj.20140099. Epub 2014 Oct 30.

Effectiveness of the Godelieve Denys-Struyf (GDS) method in people with low back pain: cluster randomized controlled trial.

Author information

1
M.J. Díaz-Arribas, MPT, PhD, Physical Medicine and Rehabilitation Department, Faculty of Medicine, Complutense University, Madrid, Spain; and the Spanish Back Pain Research Network.
2
F.M. Kovacs, MD, PhD, Scientific Department, Kovacs Foundation, Paseo de Mallorca 36, E-07012, Palma de Mallorca, Spain; and the Spanish Back Pain Research Network. fmkovacs@kovacs.org.
3
A. Royuela, PhD, CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Unidad de Bioestadística Clínica, Hospital Ramón y Cajal, IRICYS, Madrid, Spain; and the Spanish Back Pain Research Network.
4
M. Fernández-Serrano, MPT, Physical Therapy and Nursery Department, Alcalá University; and Primary Health Care Research Group (INFICAP); and the Spanish Back Pain Research Network.
5
L. Gutiérrez-Fernández, MPT, Primary Health Care Research Group (INFICAP); and the Spanish Back Pain Research Network.
6
O. San Martín-Pariente, MPT, Primary Health Care Research Group (INFICAP); and the Spanish Back Pain Research Network.
7
V. Abraira, PhD, CIBER Epidemiología y Salud Pública (CIBERESP); Unidad de Bioestadística Clínica, Hospital Ramón y Cajal, IRICYS; and the Spanish Back Pain Research Network.
8
M. Ramos-Sánchez, MD, PhD, Physical Medicine and Rehabilitation Department, Faculty of Medicine, Complutense University, Madrid, Spain.
9
R. Llorca-Palomera, MD, PhD, Physical Medicine and Rehabilitation Department, Faculty of Medicine, Complutense University.
10
P. Pardo-Hervás, MD, PhD, Physical Medicine and Rehabilitation Department, Faculty of Medicine, Complutense University.
11
M. Gestoso, MD, Scientific Department, Kovacs Foundation, Palma de Mallorca, Spain.
12
Other members of Primary Health Care Research Group (INFICAP) who authored this study are: G.C. Sánchez-Gil, M.Á. Elena-Lucas, R. Paniagua-de-la-Calle, I. Castellanos-López, M.Á. García-Heredia, A.M. Cerón-Sanz, B. Victoria-González, C. Monsalve-Martín, J.M. Duque-Heras, M.J. Juanes-Hernández, J. Saura-Contí, J.L. Soto-Sáez, C. Román-Moraleda, C. Ruiz-Arias, B. Martín-Mora, R. Escolano-García, J.S. Cantero-Bengoechea, E. García-López, A. López-Pelegrín, E. Padilla-Martin, M. Martínez-Rodríguez, J. Casillas-Martín, J. Jerez-Vázquez, and L. Barrientos-Gómez.

Abstract

BACKGROUND:

The Godelieve Denys-Struyf method (GDS) is a motor learning intervention that may be applied in group or individualized sessions.

OBJECTIVE:

The study objective was to compare the effectiveness of routine physical therapy, group GDS (GDS-G) sessions, and group and individualized GDS (GDS-I) sessions.

DESIGN:

This was a cluster randomized controlled trial.

SETTING:

The study took place in 21 primary care physical therapy units ("clusters") of the Spanish National Health Service (SNHS).

PARTICIPANTS:

The participants were 461 people with subacute and chronic low back pain (LBP).

INTERVENTION:

Clusters were randomized into 3 groups. All participants received medical treatment and a 15-minute group education session on active management. Additional interventions were as follows: control (fifteen 40-minute sessions of transcutaneous electrical nerve stimulation, microwave treatment, and standardized exercises), GDS-G (eleven 50-minute group GDS sessions), and GDS-I (the same 11 sessions plus four 50-minute individualized GDS sessions).

MEASUREMENTS:

Primary outcomes at baseline and 2, 6, and 12 months later were LBP and pain referred down the leg (separate pain intensity numeric rating scales) and disability (Roland-Morris Questionnaire [RMQ]). Secondary outcomes were use of medication and self-reported health (mental and physical component summaries of the 12-Item Short-Form Health Survey [SF-12]). Separate linear mixed models for LBP, pain referred down the leg, and disability were developed to adjust for potential confounders. Randomization, outcome assessment, and data analyses were masked.

RESULTS:

At 12 months, disability improved 0.7 (95% confidence interval [CI]=-0.4, 1.8) RMQ point in the control group, 1.5 (95% CI=0.4, 2.7) RMQ points in the GDS-I group, and 2.2 (95% CI=1.2, 3.2) RMQ points in the GDS-G group. There were no differences in pain.

LIMITATIONS:

The amount of exercise was smaller in the control group, and GDS-I sessions were provided by junior physical therapists.

CONCLUSIONS:

The improvement in disability was slightly higher with group GDS sessions than with the program routinely used in clusters within the SNHS. Adding individualized GDS sessions eliminated this advantage. Further studies should compare the GDS with other types of exercise.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01060280.

PMID:
25359444
DOI:
10.2522/ptj.20140099
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center