Alston S D, O'Sullivan T J
Back Care Programme, Dept of Orthopaedic Surgery, Waterford Regional Hospital.
Ir J Med Sci. 2005 Jul-Sep;174(3):64-9. doi: 10.1007/BF03169151.
Adults with recalcitrant mechanical low back pain of more than six weeks duration can encounter unacceptable waiting periods for specialised care.
To evaluate the effectiveness of rapid treatment by means of group sessions.
We instituted a rapidly accessed patient education programme in physiotherapy for low back pain. Pain and disability were assessed before and after the programme. The programme included four sessions of group instruction for self-actuated physiotherapy There were six to 10 patients per group.
In eight months, 160 patients were admitted to the programme. The average waiting time was 16 business days for the first appointment. Seventy-three per cent of the patients who attended some portion of the programme completed all sessions. At least 30% of the incompletions were ascribable to rapid improvement. Of patients completing the programme, 80% reported significant resolution of the pain and improvement in function. Twenty per cent reported no significant response, but no patients worsened during participation. Of the 20% with no subjective improvement, 50% were pursuing medico-legal claims. In comparison, 9% of those reporting a successful response were pursuing litigation.
Group instruction in physiotherapy for low back pain is safe, generally successful, and highly acceptable to patients.
患有顽固性机械性下背痛且病程超过六周的成年人在等待专科护理时可能会面临难以接受的等待期。
评估通过小组课程进行快速治疗的效果。
我们为下背痛患者设立了一个可快速就诊的物理治疗患者教育项目。在项目前后对疼痛和功能障碍进行评估。该项目包括四节自我驱动物理治疗的小组指导课程。每组有六至十名患者。
在八个月内，160名患者进入该项目。首次预约的平均等待时间为16个工作日。参加了部分项目的患者中有73%完成了所有课程。至少30%未完成课程的患者是因为病情迅速好转。完成项目的患者中，80%报告疼痛明显缓解且功能改善。20%报告无明显反应，但参与过程中没有患者病情恶化。在20%主观上无改善的患者中，50%正在寻求医疗诉讼。相比之下，报告有成功反应的患者中有9%正在进行诉讼。
下背痛物理治疗的小组指导是安全的，总体上是成功的，并且患者高度认可。
