Assessing the Benefit of an Educational Program in a Rehabilitation Program over a Week in 99 Patients with Chronic Low Back Pain

Abstract

Objectives: Some patients with chronic low back pain are not eligible to intensive rehabilitation program because of the intensity of their pain. We assessed the value of an educational program in a rehabilitation program over a week in chronic low back pain. Methods:Patients aged 18 to 75 years with chronic low back pain were included. The rehabilitation program took place during a five-day hospitalisation in the rheumatology department of the Rouen University Hospital involving patients receiving multidisciplinary management with collective and individual workshops with special focus on education along with structured rehabilitation exercises. On the fifth day, patients and caregivers established goals to achieve within the six-month period. Patients had a follow-up visit six months later. The objective was to evaluate whether or not the goals were achieved at 6 months later.Results: Ninety-nine patients were included, and 78 were re-evaluated after six months. The patients achieved 74% of the goals that they had established, with significant behavioural changes. Clinically and functionally: significant decrease in pain VAS during the program, significant decrease in the fingertip-to-floor distance during the program and at the 6 months follow-up, significant improvement in the functional questionnaire. Conclusion:With to the educational part of their program, the patients achieved a mean of 74% of the goals. Moreover, the training course improved pain and function. For patients with a high level of pain and/or disability our short program with multidisciplinary management and an educational approach seems to be interesting as a first step before a more intensive rehabilitation.Keywords: Chronic low back pain; Therapeutic education; Multidisciplinary management; Rehabilitation Key Points1. Some of the chronic low back pain patients rapidly develop a high level of chronic pain and disability and therefore are not eligible for back school and intensive back pain rehabilitation; for these severe patients, based on the European recommendations and the biopsychosocial model, we created a "low back pain" training session with a special reinforcement on therapeutic education. 2.The training session is a one week multidisciplinary management, with multiple individual and group workshops on the various aspects of the chronic low back pain and its consequences in the different aspects of life.3. We asked patients to set goals to achieve by the sixth month following the training course in order to give them a starting point for following their efforts once they completed the week of training, the patients achieved a mean of 75% of the goals they had set individually.4. After the week training session, the pain scale significantly decrease as well as the finger-to-floor distance, the modified Schober's test and the functional questionnaire (Roland Morris Disability Questionnaire and Dallas Pain Questionnaire)