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Communication Dans Un Congrès Année : 2012

Chronic low back pain: Effect of a program mixing ambulatory physiotherapy in the community and multidisciplinary coordination in a rehabilitation center

S Menuet
  • Fonction : Auteur
Audrey Petit
V Dubus
  • Fonction : Auteur
L Bontoux
  • Fonction : Auteur
G Roche
  • Fonction : Auteur
I Richard
  • Fonction : Auteur

Résumé

Objective.– Low back pain induces physical limitations, anxiety and depression and reduction of activity and social participation. The objective of this study is to assess the short-term effects of a program mixing ambulatory physiotherapy, provided in the community by private practice physiotherapists and multidisciplinary coordination. Methods.– Design: prospective before/after study. Population.– Sixty-four workers (37 males, mean age 42.4 ± 8.8 years) with 187.9 ± 148.7 days mean duration of sick leave during the preceding 24 months. Intervention.– Fifteen one-hour physiotherapy sessions, delivered in the community by private practice physiotherapists; 5 one-day session, in a rehabilitation center providing coordination by a physiatrist, contact with the occupational physician, advice by an occupational therapist and a psychologist, group interaction, on a 5-week period. Outcome measures.– Spine strength and flexibility, pain, psychological impact, quality of life, self assessment of ability to work. Results.– Among the patients, 87.5% have attended the scheduled physiotherapy sessions and 70.3% the multidisciplinary one day sessions. All parameters were significantly improved at the end of the program (P < 0.05). Finger-floor distance: 11.3 versus 17.6 cm; Sorensen test: 80.5 versus 60.6 sec; Ito test: 79.8 versus 53.4 sec. Pain: 42 versus 52 mm on the AVS. Quality of life DALLAS: 43.3 versus 59.2; work/leisure DALLAS: 42.6 versus 60,8; anxiety/depression DALLAS: 30,3 versus 41,3; social behavior DALLAS: 26,9 versus 32.2. HAD: 13.2 versus 15.7. FABQ: 35.1 versus 43.0. Physical SF36: 39.4 versus 34.7; mental SF36: 46.0 versus 41.4. The proportion of patients feeling able to work has significantly increased (28.3% versus 63.3%; P < 0.0001). Overall cost of the program for the social insurance system: 1532 €/patient. Discussion.– This program, mixing community based and rehabilitation center based services is both feasible, efficient on the short term, and cheaper than full time out-patient programs. Comparison to other programs could show that multidisciplinarity rather than intensity is the key component to success and can be achieved at an acceptable cost.

Dates et versions

hal-02929256 , version 1 (03-09-2020)

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Citer

S Menuet, Audrey Petit, V Dubus, L Bontoux, G Roche, et al.. Chronic low back pain: Effect of a program mixing ambulatory physiotherapy in the community and multidisciplinary coordination in a rehabilitation center. 27e Congrès de Médecine Physique et de Réadaptation, Oct 2012, Toulouse, France. pp.e285-6, ⟨10.1016/j.rehab.2012.07.720⟩. ⟨hal-02929256⟩
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