School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland,
Ir J Med Sci. 2014 Sep;183(3):341-50. doi: 10.1007/s11845-013-1013-z. Epub 2013 Sep 15.
Low back pain (LBP) can prove resistant to treatment. Conservative management in form of education and exercise is advocated as a first-line treatment option. The format of exercise programmes varies, as does the scale of improvement. Individual and group models of care are commonly utilised.
To determine the effectiveness of a group education/exercise intervention in a cohort of patients with LBP in a teaching hospital in the south east of Ireland. In addition, the study explores which factors are predictive of a positive outcome.
Patients aged 18-65 years with LBP > 6 months, who completed the programme between January 2008 and December 2010 were included. Outcome measures were coded, entered into PASW 18 and cleaned. Pre and post scores were analysed with paired t tests and χ (2) analysis. Multiple regression modelling was used to determine which baseline variables were independent predictors of positive outcome.
In total, 668 patients completed the programme. The mean age of patients was 45.9 ± 11.3 years and the majority of patients (69 %) were female. Three months post programme, significant improvements in all self report and objective physical measures were demonstrated (p < 0.001). Factors associated with a positive outcome included lower levels of baseline disability and distress, less baseline functional impairment, shorter duration of symptoms and not being involved in litigation.
This group-based education/exercise programme proved effective in terms of decreasing pain, improving physical function and improving psychosocial status. Identifying factors predictive of positive outcome may help maximise patient outcomes.
下腰痛（LBP）可能难以治疗。提倡以教育和锻炼为形式的保守治疗作为一线治疗选择。运动方案的形式不同，改善的程度也不同。通常采用个体和团体护理模式。
确定在爱尔兰东南部一所教学医院的一组 LBP 患者中，群体教育/锻炼干预的效果。此外，该研究还探讨了哪些因素是积极结果的预测因素。
纳入年龄在 18-65 岁之间、腰痛时间超过 6 个月且完成该计划的患者。将结果指标进行编码、输入 PASW 18 并进行清理。使用配对 t 检验和 χ（2）分析对治疗前后的评分进行分析。使用多元回归模型确定哪些基线变量是积极结果的独立预测因素。
共有 668 名患者完成了该计划。患者的平均年龄为 45.9±11.3 岁，大多数患者（69%）为女性。在计划完成后的 3 个月，所有自我报告和客观身体测量指标均显示出显著改善（p<0.001）。与积极结果相关的因素包括较低的基线残疾和痛苦程度、较低的基线功能障碍、较短的症状持续时间以及不参与诉讼。
该基于群体的教育/锻炼计划在减轻疼痛、改善身体功能和改善心理社会状态方面是有效的。确定积极结果的预测因素可能有助于最大限度地提高患者的治疗效果。
