Outcomes of an interdisciplinary rehabilitation programme for the management of chronic low back pain

Abstract

BACKGROUND AND CONTEXT: The health and economic costs associated with chronic low back pain (CLBP) have increased substantially over the past few decades. Despite extensive research, a consistently valid, reliable and effective diagnostic and treatment regime for CLBP is yet to be determined. ASSESSMENT OF PROBLEM: This paper presents an established interdisciplinary rehabilitation model for CLBP initially developed by the Canadian Back Institute. An audit describes the symptomatic, functional and vocational outcomes achieved for patients who attended the programme over three years throughout a national network of primary health care facilities in New Zealand. RESULTS: Over a three-year period, 899 patients with CLBP completed their rehabilitation programme at one of eight affiliated clinics. Of the 899 patients discharged, 780 (86.8%) reported that their back pain had gone or reduced at the end of their rehabilitation. There was a statistically significant, and clinically relevant, improvement in both average pain and subjective functional scores from baseline assessment levels to discharge and follow-up scores (p<0.001). STRATEGIES FOR IMPROVEMENT: Previous studies have shown that functional rehabilitation can improve outcomes in individuals with CLBP. This audit provides further support for the development of interdisciplinary functional rehabilitation programmes to help manage CLBP within the community. LESSONS: The routine measurement of symptomatic, functional and vocational outcomes throughout the rehabilitation process can assist in quantifying the effect of treatment and providing evidence of value for patients, stakeholders and funding groups. KEYWORDS: Low back pain; outcomes; rehabilitation