A 10-year follow-up of tailored behavioural treatment and exercise-based physiotherapy for persistent musculoskeletal pain.Clinical Rehabilitation, 31(2): [186][187][188][189][190][191][192][193][194][195][196] https://doi.org/10.1177/0269215516639356Access to the published version may require subscription. N.B. When citing this work, cite the original published paper.
Key wordsChronic pain, Behavioural medicine, Primary care, Physical exercise, Long-term compliance
Funding sourcesThe study received financial support from the Swedish Rheumatism Association, Uppsala County Council, and Caring Sciences Funding at the Faculty of Medicine, Uppsala University.
Conflicts of interestNone declared. The manuscript contains original unpublished work and is not being submitted for publication elsewhere. All authors meet the criteria for authorship, and all authors discussed the results and commented on the manuscript. The study was approved by the regional ethical review board in Uppsala.
AbstractObjective: To study the long-term outcomes of two interventions targeting patients with subacute 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 exercisebased 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.