Cuesta-Vargas Antonio I, White Melanie, González-Sánchez Manuel, Kuisma Raija
Departamento de Psiquiatría y Fisioterapia, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (AE-14), Universidad de Malaga , Andalucia Tech, Malaga , Spain .
Disabil Rehabil. 2015;37(4):311-8. doi: 10.3109/09638288.2014.918191. Epub 2014 May 12.
To establish whether there was a difference in health-related quality of life (HRQoL) in people with chronic musculoskeletal disorders (PwCMSKD) after participating in a multimodal physiotherapy program (MPP) either two or three sessions a week.
Total of 114 PwCMSKD participated in this prospective randomised controlled trial. An individualised MPP, consisting of exercises for mobility, motor-control, muscle strengthening, cardiovascular training, and health education, was implemented either twice a week (G2: n = 58) or three times a week) (G3: n = 56) for 1 year.
HRQoL physical and mental health state (PHS/MHS), Roland Morris disability Questionnaire (RMQ), Neck-Disability-Index (NDI) and Western Ontario and McMaster Universities' Arthritis Index (WOMAC) were used to measure outcomes of MPP for people with chronic low back pain, chronic neck pain and osteoarthritis, respectively. Measures were taken at baseline, 8 weeks (8 w), 6 months (6 m), and 1 year (1 y) after starting the programme.
No statistically significant differences were found between the two groups (G2 and G3), except in NDI at 8 w (-3.34, (CI 95%: -6.94/0.84, p = 0.025 (scale 0-50)). All variables showed improvement reaching the following values (from baseline to 1 y) G2: PHS: 57.72 (baseline: 41.17; (improvement: 16.55%), MHS: 74.51 (baseline: 47.46, 27.05%), HRQoL 0.90 (baseline: 0.72, 18%)), HRQoL-VAS 84.29 (baseline: 58.04, 26.25%), RMQ 4.15 (baseline: 7.85, 15.42%), NDI 3.96 (baseline: 21.87, 35.82%), WOMAC 7.17 (baseline: 25.51, 19.10%). G3: PHS: 58.64 (baseline: 39.75, 18.89%), MHS: 75.50 (baseline: 45.45, (30.05%), HRQoL 0.67 (baseline: 0.88, 21%), HRQoL-VAS 86.91 (baseline: 52.64, 34.27%), RMQ 4.83 (baseline: 8.93, 17.08%), NDI 4.91 (baseline: 23.82, 37.82%), WOMAC 6.35 (baseline: 15.30, 9.32%).
No significant differences between the two groups were found in the outcomes of a MPP except in the NDI at 8 weeks, but both groups improved in all variables during the course of 1 year under study. Implications for Rehabilitation A multimodal physiotherapy program (MPP) improves quality of life, overall health, and function in people with chronic musculoskeletal disease after an intervention of short, medium and long term. This implies that twice a week MPP for people with chronic musculoskeletal pain has comparable results to three times a week provision and therefore may have implications in saving resources and cost for patients and service providers without compromising the outcomes of treatment. These results can be considered not only for therapists, but also for managers who offer the services to optimise the balance cost-effectiveness of the proposed interventions.
确定慢性肌肉骨骼疾病患者（PwCMSKD）在参加每周两次或三次的多模式物理治疗计划（MPP）后，其健康相关生活质量（HRQoL）是否存在差异。
共有114名PwCMSKD参与者参加了这项前瞻性随机对照试验。针对移动性、运动控制、肌肉强化、心血管训练和健康教育进行个体化的MPP，每周实施两次（G2：n = 58）或每周三次（G3：n = 56），为期1年。
使用HRQoL身体和心理健康状态（PHS/MHS）、罗兰·莫里斯残疾问卷（RMQ）、颈部残疾指数（NDI）和西安大略和麦克马斯特大学关节炎指数（WOMAC）分别测量慢性下腰痛、慢性颈痛和骨关节炎患者MPP的结果。在项目开始后的基线、8周（8 w）、6个月（6 m）和1年（1 y）进行测量。
除了在8周时NDI存在差异外（-3.34，（95%CI：-6.94/0.84，p = 0.025（范围0 - 50）），两组（G2和G3）之间未发现统计学上的显著差异。所有变量均显示改善，达到以下值（从基线到1年）G2：PHS：57.72（基线：41.17；改善：16.55%），MHS：74.51（基线：47.46，27.05%），HRQoL 0.90（基线：0.72，18%），HRQoL - VAS 84.29（基线：58.04，26.25%），RMQ 4.15（基线：7.85，15.42%），NDI 3.96（基线：21.87，35.82%），WOMAC 7.17（基线：25.51，19.10%）。G3：PHS：58.64（基线：39.75，18.89%），MHS：75.50（基线：45.45，30.05%），HRQoL 0.67（基线：0.88，21%），HRQoL - VAS 86.91（基线：52.64，34.27%），RMQ 4.83（基线：8.93，17.08%），NDI 4.91（基线：23.82，37.82%），WOMAC 6.35（基线：15.30，9.32%）。
除了8周时的NDI外，两组在MPP结果上未发现显著差异，但在研究的1年过程中，两组所有变量均有所改善。康复意义多模式物理治疗计划（MPP）在短期、中期和长期干预后可改善慢性肌肉骨骼疾病患者的生活质量、整体健康和功能。这意味着对于慢性肌肉骨骼疼痛患者，每周两次的MPP与每周三次的效果相当，因此可能在不影响治疗效果的情况下，为患者和服务提供者节省资源和成本。这些结果不仅可供治疗师参考，也可供提供服务的管理人员参考，以优化所提议干预措施的成本效益平衡。
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