%0 Journal Article %T Efficiency of three treatment strategies on occupational and quality of life impairments for chronic low back pain patients is the multidisciplinary approach the key feature to success? %+ Centre Hospitalier Universitaire d'Angers (CHU Angers) %+ PRES Université Nantes Angers Le Mans (UNAM) %A Ronzi, Yoann %A Roche-Leboucher, Ghislaine %A Bègue, Cyril %A Dubus, Valerie %A Bontoux, Luc %A Roquelaure, Yves %A Richard, Isabelle %A Petit, Audrey %Z 2008-A00900-55, Institut National de la Santé et de la Recherche Médicale %< avec comité de lecture %@ 0269-2155 %J Clinical Rehabilitation %I SAGE Publications %V 31 %N 10 %P 1364-1373 %8 2017-10 %D 2017 %R 10.1177/0269215517691086 %M 28592147 %K private physiotherapy %K Chronic low back pain %K mixed strategies %K multidisciplinary rehabilitation %Z Life Sciences [q-bio]/Santé publique et épidémiologieJournal articles %X Objective - To compare the effectiveness of three treatment strategies for chronic low back pain with varying biomechanical intensity and multidisciplinary approach. Methods - A monocentric randomized controlled trial with a 12-months follow-up, conducted in the French Valley Loire region from May 2009 to April 2013. Participants were working-aged patients with chronic low back pain referred to a French chronic low back pain care-network to support medical and occupational issues. Three treatment strategies, each for five weeks were compared: (i) intensive and multidisciplinary program conducted in a rehabilitation center; (ii) less intensive outpatient program conducted by a trained private physiotherapist; (iii) mixed strategy combining the same outpatient program associated with a weekly multidisciplinary intervention. The effects of treatment conditions were compared using an "intention to treat" approach: Number of days' sick leave during the 12-months following treatment, and quality of life and social ability assessed by auto-questionnaires. Results - A total of 159 patients (58.9% men, 41.5 ± 10.3 years old, median duration of sick leave = 221.0 days (127.5-319.0)) were included. Sick leave duration significantly decreased during the 12-months following treatment in the three groups. There was no significant difference for the evolution of participants' quality of life, social ability, and personal beliefs between the three groups. Conclusion - This study confirms that disparate treatments might show similar effectiveness because they could all work through concomitant changes in beliefs, attitudes, and coping mechanisms. The original mixed strategy can treat a larger number of chronic low back pain patients, at a lower cost and provide local community-based care. Clinical trial registration - NCT02030171. %G English %L hal-01881590 %U https://univ-rennes.hal.science/hal-01881590 %~ SANTE_PUB_INSERM %~ UNAM %~ IRSET %~ STATS-UR1 %~ UR1-UFR-SVE %~ UR1-SDV %~ IRSET-10 %~ UNIV-RENNES %~ UR1-BIO-SA