J Orthop Sports Phys Ther. 2024 Oct;54(10):634-646. doi: 10.2519/jospt.2024.12618.
To assess the effectiveness of a single session of education and exercise compared with multiple sessions of a multimodal physiotherapy intervention for adults with spinal disorders in an advanced practice physiotherapy specialized spine model of care. Pragmatic randomized controlled trial. We randomized patients with spinal disorders, who were referred for a spinal surgery consultation and triaged as nonsurgical cases by an advanced practice physiotherapist, to a single session of education and prescription of an exercise program (n = 52) or multiple sessions (6 in total) of a multimodal physiotherapy intervention (n = 54). The primary outcomes were the short form Brief Pain Inventory pain severity scale (BPI-S) and the Brief Pain Inventory pain interference scale (BPI-I), and secondary outcomes included disability, quality of life, catastrophization, and satisfaction. Linear mixed models were used to assess differences between groups across time points at 6, 12, and 26 weeks. There were no significant between-group differences on the BPI-S and only a significant improvement at 6 weeks on the BPI-I in the multiple-session group (mean difference: -0.96/10; 95% CI, -1.87 to -0.05). There were no other statistically significant differences between groups, except for satisfaction where participants in the multiple-session group reported statistically significantly greater satisfaction on the 9-item Visit-Specific Satisfaction Questionnaire and the MedRisk questionnaire. Both groups saw significant improvements over time on all outcomes except for the BPI-S. Adding supervised multimodal physiotherapy sessions did not result in better clinical outcomes when compared to a single session of education and exercise. Patients were more satisfied with the multiple-session approach. .
在高级实践物理治疗的专业化脊柱护理模式下，评估单次教育和运动与多次多模式物理治疗干预对脊柱疾病成人的疗效。 实用随机对照试验。 我们将脊柱疾病患者随机分为单次教育和运动处方组（n=52）或多次多模式物理治疗干预组（n=54）。主要结局指标是简短疼痛量表（BPI-S）和简短疼痛量表（BPI-I）的疼痛干扰量表，次要结局指标包括残疾、生活质量、灾难化和满意度。线性混合模型用于评估 6、12 和 26 周时组间的差异。 在 BPI-S 上，两组之间没有显著差异，只有在多次治疗组中，BPI-I 在 6 周时有显著改善（平均差异：-0.96/10；95%可信区间，-1.87 至-0.05）。除了满意度，两组之间没有其他统计学上的显著差异，在 9 项就诊特异性满意度问卷和 MedRisk 问卷中，多次治疗组的参与者报告了统计学上更高的满意度。除了 BPI-S，两组在所有结局上都随着时间的推移有显著改善。 与单次教育和运动相比，增加监督多模式物理治疗并不会导致更好的临床结局。患者对多次治疗方法更满意。
