A 10-year follow-up of tailored behavioural treatment and exercise-based physiotherapy for persistent musculoskeletal pain. (February 2017)

• Record Type: Journal Article
• Authors: Emilson, Christina; Demmelmaier, Ingrid; Bergman, Stefan; Lindberg, Per; Denison, Eva; Åsenlöf, Pernilla
• Is Part Of: Clinical rehabilitation. Volume 31:Number 2(2017)
• Page Start: 186
• Page End: 196
• Publication Date: 2017-02
• Subjects: Chronic pain -- behavioural medicine -- primary care -- physical exercise -- long-term compliance; Medical rehabilitation -- Periodicals; 617.03
• DOI: 10.1177/0269215516639356
• Languages: English
• ISSNs: 0269-2155

Abstract

Objective: To study the long-term outcomes of two interventions targeting patients with sub-acute and persistent pain in a primary care physiotherapy setting. Design: A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants. Interventions: Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition). Main measures: Pain-related disability was the primary outcome. The maximum pain intensity, pain control, fear of movement, sickness-related absence (register data) and perceived benefit and confidence in coping with future pain problems were the secondary outcomes. Results: Forty-three (44%) participants responded to the follow-up survey, 20 in the tailored behavioural medicine treatment group and 23 in the exercise-based physiotherapy group. The groups did not differ in terms of the change in the scores for the primary outcome ( p =0.17) of pain-related disability between the experimental group (median: 2.5, Q1-Q3: -2.5-14.25), and the control group (median: 0, Q1-Q3: -5-6). Further, there were also no significant differences found for the secondary outcomes except for sickness-related absence, where the exercise-based physiotherapy group had more days of sickness-related absence three months before treatment ( p = 0.02), and at the 10-year follow-up ( p =0.03). Discussion: The beneficial effects favouring tailored behavioural medicine treatment that observed post-treatment and at the two-year follow-up were not maintained 10 years after treatment.