Ribeiro L H, Jennings F, Jones A, Furtado R, Natour J
São Paulo Federal University, Division of Rheumatology, São Paulo, Brazil.
Clin Exp Rheumatol. 2008 Jan-Feb;26(1):81-8.
To evaluate the effectiveness of a back school program in pain, functional status, quality of life, and in anxiety and depression in patients with non-specific low back pain.
Sixty patients with low back pain were randomized to an intervention and control group. The intervention group underwent a five-weekly back school program. The control group was seen in weekly medical visits, without educative approaches. Both groups took acetaminophen as analgesic medication. All subjects were evaluated by a blind physiotherapist after randomization, 30, 60 and 120 days. Rolland-Morris, SF-36, STAI and Beck questionnaires, pain visual analogical scale and Schober's test were applied. Non-steroidal anti-inflammatory drugs (NSAID) consumption was considered co-intervention. The statistical analyses were performed using Pearson's Chi-Square analysis and Student's t-test to compare the baseline characteristics of the groups and the analysis of variance (ANOVA) with repeated measures to assess changes inter/intra groups.
There were no significant differences in the baseline characteristics between the two groups. Fifty-five patients completed the study. The intervention group showed a significant improvement in the general health domain, assessed by SF-36, and also in the reduction of acetaminophen and NSAID intake. There was no significant difference between the groups in pain, functional status, anxiety or depression.
The back school program was more effective than any educational intervention in general health status and in decreasing acetaminophen and NSAID intake. It was ineffective in the other quality of life domains, in pain, functional status, anxiety and depression.
评估一项腰痛康复课程对非特异性下腰痛患者的疼痛、功能状态、生活质量以及焦虑和抑郁状况的效果。
60例腰痛患者被随机分为干预组和对照组。干预组接受为期五周的腰痛康复课程。对照组每周接受一次医疗问诊，但不采用教育方法。两组均服用对乙酰氨基酚作为止痛药物。所有受试者在随机分组后、第30天、第60天和第120天由一名盲法物理治疗师进行评估。应用罗兰-莫里斯问卷、SF-36问卷、状态-特质焦虑问卷（STAI）和贝克问卷、疼痛视觉模拟量表以及肖伯试验。非甾体抗炎药（NSAID）的使用被视为联合干预。采用Pearson卡方分析和学生t检验进行统计分析，以比较两组的基线特征，并采用重复测量方差分析（ANOVA）来评估组间/组内的变化。
两组的基线特征无显著差异。55例患者完成了研究。干预组在通过SF-36评估的总体健康领域有显著改善，并且对乙酰氨基酚和NSAID的摄入量也有所减少。两组在疼痛、功能状态、焦虑或抑郁方面无显著差异。
腰痛康复课程在总体健康状况以及减少对乙酰氨基酚和NSAID摄入量方面比任何教育干预都更有效。在其他生活质量领域，如疼痛、功能状态、焦虑和抑郁方面则无效。
