Storrø Sturla, Moen Janne, Svebak Sven
Clinic of Physical Medicine 3T, Trondheim, Norway.
J Rehabil Med. 2004 Jan;36(1):12-6. doi: 10.1080/11026480310015521.
To test the outcome of active multidisciplinary treatment in an outpatient setting upon sick-leave status among patients with neck, shoulder and low back pain.
Multidisciplinary treatment was administered to 121 patients (intervention group) over 4 weeks of structured intervention, followed by 8 weeks of less structured consultations. Effects of treatment were compared with usual treatment (control group: n = 97).
All patients were in the chronic stage of pain (average sick-leave: 6 months) with different diagnoses: neck-shoulder pain, low back pain or low back pain with radiating extremity pain.
The intervention group programme included posture corrections, pain perception, skills to cope with pain, aerobic and fitness-promoting activities and relaxation techniques administered to groups of 8-10 patients. The Local National Insurance Office referred the patients who were diagnosed by general practitioners. A 12-month follow-up by the Local National Insurance Office provided feedback about sick-leave status of all 218 patients.
There was a significant treatment difference in proportion taken off the sick list after 12 months (intervention group: 78.5%; control group: 50.5%; p < 0.001). The difference was greater among low back pain (p < 0.001) than among neck-shoulder (p < 0.053) and low back pain with radiating extremity pain (p < 0.031) patients.
Long-term effects of active multidisciplinary treatment were superior to treatment as usual in all diagnostic groups.
测试门诊环境下积极多学科治疗对颈肩痛和腰背痛患者病假状态的影响。
对121名患者（干预组）进行了为期4周的结构化干预多学科治疗，随后是8周结构较松散的咨询。将治疗效果与常规治疗（对照组：n = 97）进行比较。
所有患者均处于疼痛慢性期（平均病假：6个月），诊断各不相同：颈肩痛、腰背痛或伴有肢体放射性疼痛的腰背痛。
干预组方案包括姿势矫正、疼痛感知、应对疼痛的技巧、有氧运动和促进健康的活动以及放松技巧，以8 - 10名患者为一组进行。当地国家保险办公室转诊了由全科医生诊断的患者。当地国家保险办公室进行了为期12个月的随访，提供了所有218名患者病假状态的反馈。
12个月后从病假名单上除名的比例存在显著治疗差异（干预组：78.5%；对照组：50.5%；p < 0.001）。腰背痛患者（p < 0.001）的差异大于颈肩痛患者（p < 0.053）和伴有肢体放射性疼痛的腰背痛患者（p < 0.031）。
在所有诊断组中，积极多学科治疗的长期效果优于常规治疗。
