Rheumatology Advance Access published online on October 24, 2006
Rheumatology, doi:10.1093/rheumatology/kel339
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Institute of Rehabilitation, University of Hull, Hull, UK
* To whom correspondence should be addressed. Objectives. Interventions that take psychosocial factors into account are recommended for patients with persistent back or neck pain. We compared the effectiveness of a brief physiotherapy pain management approach using cognitive-behavioural principles (Solution-Finding Approach--SFA) with a commonly used method of physical therapy (McKenzie Approach--McK). Methods. Eligible patients referred by GPs to physiotherapy departments with neck or back pain lasting at least 2 weeks were randomized to McK (n = 161) or to SFA (n = 154). They were further randomized to receive an educational booklet or not. The primary outcome was the Tampa Scale of Kinesiophobia (TSK) (Activity-Avoidance scale used as a proxy for coping) at 6 weeks, and 6 and 12 months. Results. Of 649 patients assessed for eligibility, 315 were recruited (219 with back pain, 96 with neck pain). There were no statistically significant differences in outcomes between the groups, except that at any time point SFA patients supported by a booklet reported less reliance on health professionals (Multidimensional Health Locus of Control Powerful Others Scale), while at 6 months McK patients showed slightly more improvement on activity-avoidance (TSK). At 6 weeks, patient satisfaction was greater for McK (median 90% compared with 70% for SFA). Both interventions resulted in modest but clinically important improvements over time on the Roland Disability Questionnaire Scores and Northwick Park Neck Pain Scores. Conclusions. The McK approach resulted in higher patient satisfaction overall but the SFA could be more cost-effective, as fewer (three vs four) sessions were needed.
Received May 4, 2006
Accepted September 1, 2006
Original Papers
Randomized trial of two physiotherapy interventions for primary care neck and back pain patients: ‘McKenzie’ vs brief physiotherapy pain management
J. Klaber Moffett 1 *, D. A. Jackson 1, E. D. Gardiner 1, D. J. Torgerson 2, S. Coulton 2, S. Eaton 1, M. P. Mooney 1, C. Pickering 1, A. J. Green 3, L. G. Walker 4, S. May 5, and S. Young 6
2 York Trials Unit, Department of Health Sciences, University of York, Hull, UK
3 Hull and East Yorkshire NHS Hospital Trust, Hull, UK
4 Institute of Rehabilitation, University of Hull, Hull, UK; Oncology Health Centres, Hull and East Yorkshire Hospitals NHS Trust, UK
5 Sheffield Hallam University, Sheffield, UK
6 Physiotherapy Department, Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, UK
J. Klaber Moffett, E-mail: j.k.moffett{at}hull.ac.uk
Abstract 
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Soares and J. C Dumville Economic evaluation of healthcare technologies using primary research Evid. Based Nurs., July 1, 2008; 11(3): 67 - 71. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Manca, J. C. Dumville, D. J. Torgerson, J. A. Klaber Moffett, M. P. Mooney, D. A. Jackson, and S. Eaton Randomized trial of two physiotherapy interventions for primary care back and neck pain patients: cost effectiveness analysis Rheumatology, September 1, 2007; 46(9): 1495 - 1501. [Abstract] [Full Text] [PDF]
|
|