• Anne-Sylvie Steiner, Marlène Sartori, Sandra Leal, Danièle Kupper, Jean-Paul Gallice, Denis Rentsch, Christine Cedraschi, and Stéphane Genevay.
• Division of primary care medicine, Department of Community Medicine and Primary Care, University Hospitals of Geneva, Switzerland. annesylviesteiner@hotmail.com
• Swiss Med Wkly. 2013 Jan 1;143:w13763.

BackgroundSeveral treatments exist for chronic low back pain (cLBP) patients although none has shown superiority. Among group treatments, muscle reconditioning programmes (MRPs) are the most commonly used. Multidisciplinary functional rehabilitation programmes (MFRPs) are an alternative.ObjectiveTo compare a MFRP with a MRP as few studies compare these treatmentsMethodsThis was a prospective, nonrandomised, controlled study comparing cLBP patients participating in a MRP or MFRP in an outpatient setting. The predetermined primary outcome measure was the daily life activity subscale (DLA) of the Dallas Pain Questionnaire (DPQ) within one year after the end of the treatment.ResultsTwenty-one patients were included in the MRP and 24 in the MFRP. At inclusion, the groups were similar in terms of age (mean 40 years), sex (50%-60% males), sick leave duration (mean 6.0 months, standard deviation (SD) 4.4 months) and follow up (mean 9.0 months, SD 2.0 months). The DLA score decreased from 59.5% (SD 16.9) to 44.8% (SD 25.4), p <0.01, in the MFRP and from 62.3 (SD 20.3) to 58.8 (SD 20.7), p = 0.3, in the MRP. The between-groups difference at follow-up was 13.8, p = 0.05, and the difference in the mean improvement was -11.5 (5.9), p = 0.058. Seventy-eight percent of MFRP patients versus 47 % in the MRP group returned to work (p = 0.08).DiscussionIn a population of highly disabled cLBP patients, MFRP seems more effective in increasing function and return to work. Interpretation is limited by the small population included and by the type of trial.ConclusionRandomised studies are needed to confirm these results and explore the cost-effectiveness of MFRP.

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