Treatment of Chronic Low Back Pain A Randomized Clinical Trial Comparing Multidisciplinary Group-based Rehabilitation Program and Oral Drug Treatment With Oral Drug Treatment Alone


Abstract: This randomized clinical trial examined the efficacies of a group-based multidisciplinary rehabilitation program and oral drug treatment versus oral drug treatment alone in Iran. Methods: A total of 197 patients with chronic low back pain were randomized to either intervention group (n=97) receiving a groupbased, 5-session multidisciplinary rehabilitation program plus oral medication or to control group (n=100) receiving just oral medication. At baseline and at 3 and 6-month follow-ups, patients filled out questionnaires on health-related quality of life (36-item Short-form General Health Survey) and disability Questionnaires (Quebec Disability Scale and Ronald-Morris Disability). Repeated measure analysis of variance was used to compare 2 groups during time. Results: The 2 groups were comparable regarding all baseline characteristics (P>0.05). There were significant differences within each group by time in terms of all subscales of 36-item Short-form (P<0.01) except for mental health (P=0.7). Furthermore, there were significant deferences between groups in terms of all domains of SF-36 scale except for general health (P=0.06), social function (P=0.08) and role emotional (P=0.7). Furthermore, according to the scores of Ronald-Morris Disability Questionnaire and Quebec Disability Scale, the disability of patients in the intervention group was improved over time significantly (P=0.01 and P<0.0001, respectively). Discussion: The findings revealed that the group-based multidisciplinary program could improve most domains of quality of life in chronic low back pain patients in the 6-month period. However, there were no significant differences between two groups in sub scales such as general health, social function and role emotional. Key Words: chronic low back pain, multidisciplinary rehabilitation program, quality of life, disability, clinical trial, Iran