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Free Content Physiotherapist-led Exercise Classes for Low Back Pain Show Changes in Disability and Fear of Movement: A service evaluation

Objective: This evaluation aimed to examine the effects of physiotherapist-led back classes in a health care setting on measures of disability and pain-related fear of movement.

Design: A service evaluation of pre- and post-class outcome measures with additional follow-up at 6 months and 1 year.

Participants: 447 participants (299 women) with low back pain [LBP] (with or without leg pain).

Interventions: Six sessions, one hour per week, of 'Back to Fitness' physiotherapist-led exercise classes for LBP based on a biopsychosocial approach.

Outcome Measures: Roland Morris Disability Questionnaire (RMDQ) and the Tampa Scale of Kinesiophobia 13 (TSK-13).

Results: Of the 447 participants, 210 participants completed baseline and week 6 outcome measures (47%). 218 were sent 6 month follow up questionnaires and 59 responded (27%). The 59 responders from the 6 month follow up were sent 1 year follow up questionnaires to which 21 responded (36%). Significant and clinically relevant reductions in RMDQ were seen immediately post class. Further reductions were seen at 6 months and 12 months with a 50% [2.3 points, p<0.05] reduction in mean RMDQ score at 1 year. TSK-13 scores significantly reduced in a similar pattern though the results at one year were not statistically significant.

Conclusions: 'Back to Fitness' physiotherapist-led exercise classes can reduce disability and pain-related fear of movement in patients with LBP. Reductions in disability were maintained for up to one year. Given the non-controlled nature of this evaluation we cannot attribute cause and effect. The large dropout rate also warrants caution when interpreting these results. However, these findings suggest that the effects of group exercise classes reported in the literature can be reasonably generalised to the modern day real world NHS setting.

Keywords: BACK CLASS; DISABILITY; LOW BACK PAIN; NHS; PHYSIOTHERAPY; SERVICE EVALUATION

Document Type: Research Article

Publication date: June 1, 2016

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  • Pain and Rehabilitation is a peer-reviewed, Bi-annual journal of the Physiotherapy Pain Association and special interest group of the Chartered Society of Physiotherapy. The journal comprises a range of different articles types from orignial articles to systematic reviews and letters around the topic of pain and rehabilitation. The journal is multidisciplinary in its focus and welcomes submissions from all professionals working in this multidisciplinary field. the abstract of all articles will be freely avilable online. Full text articles are available free online to members of the Physiotherapy Pain Association, and access to individual PDF articles can be purchased by non members.
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