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Clin Rehabil. 2017 Feb;31(2):186-196. doi: 10.1177/0269215516639356. Epub 2016 Jul 10.

A 10-year follow-up of tailored behavioural treatment and exercise-based physiotherapy for persistent musculoskeletal pain.

Author information

1
1 Department of Neuroscience, Uppsala University, Uppsala, Sweden.
2
2 Research and Development Center Spenshult, Halmstad, Sweden. Department of Public Health, and Community medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
3
3 Department of Psychology, Uppsala University, Uppsala, Sweden.
4
4 School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.

Abstract

OBJECTIVE:

To study the long-term outcomes of two interventions targeting patients with sub-acute and persistent pain in a primary care physiotherapy setting.

DESIGN:

A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants.

INTERVENTIONS:

Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition).

MAIN MEASURES:

Pain-related disability was the primary outcome. The maximum pain intensity, pain control, fear of movement, sickness-related absence (register data) and perceived benefit and confidence in coping with future pain problems were the secondary outcomes.

RESULTS:

Forty-three (44%) participants responded to the follow-up survey, 20 in the tailored behavioural medicine treatment group and 23 in the exercise-based physiotherapy group. The groups did not differ in terms of the change in the scores for the primary outcome ( p=0.17) of pain-related disability between the experimental group (median: 2.5, Q1-Q3: -2.5-14.25), and the control group (median: 0, Q1-Q3: -5-6). Further, there were also no significant differences found for the secondary outcomes except for sickness-related absence, where the exercise-based physiotherapy group had more days of sickness-related absence three months before treatment ( p= 0.02), and at the 10-year follow-up ( p=0.03).

DISCUSSION:

The beneficial effects favouring tailored behavioural medicine treatment that observed post-treatment and at the two-year follow-up were not maintained 10 years after treatment.

KEYWORDS:

Chronic pain; behavioural medicine; long-term compliance; physical exercise; primary care

PMID:
27009057
DOI:
10.1177/0269215516639356
[Indexed for MEDLINE]

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