• Nicole van der Roer, Maurits W van Tulder, Johanna M Barendse, Willem van Mechelen, Willemien K Franken, Arjan C Ooms, and Henrica C W de Vet.
• Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands. n.vanderroer@vumc.nl
• Bmc Musculoskel Dis. 2004 Jan 1;5:45.

BackgroundLow back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably.MethodsIn a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or medical specialist are included in the study. The intensive group training protocol combines exercise therapy with principles of behavioural therapy ("graded activity") and back school. This training protocol is compared to physiotherapy care according to the recently published Low Back Pain Guidelines of the Royal Dutch College for Physiotherapy. Primary outcome measures are general improvement, pain intensity, functional status, work absenteeism and quality of life. The direct and indirect costs will be assessed using cost diaries. Patients will complete questionnaires at baseline and 6, 13, 26 and 52 weeks after randomisation.DiscussionNo trials are yet available that have evaluated the effect of an intensive group training protocol including behavioural principles and back school in a primary physiotherapy care setting and no data on cost-effectiveness and cost-utility are available.

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