2. Professor (at time of study), University of Brussels, faculty of Rehabilitation science and physical therapy, faculty of Pharmacy and medicine, Brussels, Belgium.
3. Senior Lecturer, Assistant Professor (at time of study), University of Brussels, faculty of Rehabilitation science and physical therapy, faculty of Pharmacy and medicine, Brussels, Belgium.
Study design: One-way, mixed, real experimental RCT study.
Background: A multimodal physiotherapeutic approach to treat non-specific (NSP) Chronic Low Back Pain (CLBP), may affect the quality of life (QoL), pain intensity (PI) and active range of motion (AROM). The 4 X T method by orthopaedic disorder® (4MTOR®) is a decision tree to guide the physical therapist to treat NSP-CLBP.
Objectives: To investigate the measureable impact on the QoL, PI and the AROM in patients with NSPCLBP, after physiotherapeutic back rehabilitation care according to the 4MTOR® , twice a week during a 6 weeks period.
Methods: This was a RCT, where the experimental group (EGR) received the 4MTOR® compared to an control group (CGR) who received exercise therapy with sham application. The subjects were randomly assigned to one of the two groups. Both groups received physiotherapeutic intervention twice a week for a period of six weeks.
Results: The QoL in the EGR significantly improved on the EQ-5D-index p=0.001. The QoL measured with the EQ-VAS, did significantly improve in both groups p<0.001. However, only a clinically important change was found for the EGR (W0= 59.72±SD15.43 to W7=78.63± SD17.14). The flexion AROM increased significantly (p<0.005) in the EGR (W0=87.53±SD20.45, W3=96.29±SD16.34, W7= 98.28±SD17.01). A significant (p<0.01) change was also seen for the extension AROM in the EGR (W0= 19.36±SD9.27,W3= 22.25±SD5.99, W7=25.55±SD7.30). The PI reduced only significantly in the EGR during active flexion (p<0.001). The extension PI did not significantly decrease in both groups, however, a clinically important change was found in the EGR.
Conclusion: The positive effects of the 4MTOR® on the Qol, PI and AROM in NSP-CLBP exceeded the effect of exercise therapy with sham application. Further research is required.
Keywords: Low back/lumbar spine, Multimodal Physical therapy interventions, Quality of life, Range of Motion, Pain. Chronic complaints