Multicenter multidisciplinary training program for chronic low back pain: French experience of the Renodos back pain network (Réseau Nord-Pas-de-Calais du DOS).

OBJECTIVES

To evaluate the short- and long-term effectiveness of the multidisciplinary training program (MTP). To show the benefits which the network organization brings to the treatment of chronic low back pain (CLPB).

METHODS

The member centres of the Renodos back pain network included 748 subjects in the MTP. The centres used a common evaluation protocol including pain and quality of life visual analogue scales (VAS), fingertip-to-floor distance (FFD), muscle isometric endurance tests, Roland-Morris Disability Questionnaire (RDQ), the Dallas Pain Questionnaire (DPQ) and the Hospital Anxiety Depression (HAD) scale. Measurements were carried out before (T0) and immediately after (T1) the intervention, and at the 3-, 6-, 12-month (T3, T6, T12) follow-up visits.

RESULTS

Statistically discernible improvement occurred for men and women on every outcome measure from before to after the MTP (T0-T1, p<0.0001). This improvement obtained at T1 was maintained for most of the outcome measures throughout the 12-month follow-up. However, the pain intensity and isometric muscle endurance times showed significant negative evolution. Significant differences between genders were found for the trunk flexibility measurement (FFD), the isometric endurance time of the quadratus lumborum muscle, the RDQ and the HAD depression. There was no time-gender interaction.

CONCLUSION

The MTP was effective in reducing back pain intensity, functional disability, symptoms of anxiety and depression and in improving quality of life, flexibility and isometric muscle endurance time. It was possible to propose the MTP to both men and women. A network organization effectively contributes to the harmonization of evaluation methods and brings coherence to the treatment of CLBP patients.