Authors (including presenting author) :
YL Wong(1), PY Chan(1), KY Fung(1), CM Li(1)
Affiliation :
(1) Physiotherapy Department, Kwong Wah Hospital
Introduction :
In out-patient physiotherapy setting, recurrent chronic non-specific back pain referrals are common. Common causes of pain are of overuse, postural problems and degenerative changes.
Objectives :
In order to shorten the waiting time for these recurrent chronic back patients, a trail of early interventional back education class program was launched in our physiotherapy department.
Methodology :
Patients with diagnosis of non-specific back pain, received previous physiotherapy treatment within 1 year, were recruited to participate the back educational class program. There were six patients in each class consisting of two one-hour sessions and two weeks apart. The class composed of knowledge on human ergonomics, body biomechanics, optimal posture, self-management of pain, back mobilization and strengthening exercises. Heat therapy (hot pack) were provided at the classes. Brief back assessment was done in the first session and at the end of the second session. Back care booklet and exercise log sheet were given. Numeric pain rating score (NPRS) and Roland Morris Disability Questionnaire (RMDQ) were used as outcome measures. In case the patients had the following conditions, their RMDQ increased ≥30%1 or NPRS increased ≥2 2 after the class, additional individual treatment sessions would be offered to those patients.
Result & Outcome :
Forty-two patients were recruited and thirty-five patients (10 male & 25 female) completed the program. The average waiting time for first appointment were advanced from 50 weeks to 10 weeks. The mean age was 65.9 years old. The average median score of pre-NPRS was 6±2 while post-NPRS score was 5±2. The average median score of pre-RMDQ was 11±5 whereas the post-RMDQ score was 10±5. There was significance difference showed on RMQD score (p-value 0.01, Wilcoxon-signed-ranks test). No patients required additional individual treatment sessions eventually.
Conclusion
The trial of 2-class back education program maybe effective to provide early intervention physiotherapy to middle-aged and elderly patients with recurrent chronic non-specific back pain. The level of disability could be decreased which were reflected by improvement of RMDQ scores. The waiting time of physiotherapy appointment for this type patients could also be shortened. Further large scale of recruitment can be implemented to review the treatment effect.
