Evaluation of a multi-disciplinary back pain rehabilitation programme--individual and group perspectives
Andrew Baird1, Lisa Worral, Cheryl Haslam
1Centre for Psychological Research, University of Derby, Kedlestone Road, Derby DE22 1GB, UK. A.Baird@derby.ac.uk
Objective:
To evaluate the impact of a multi-disciplinary back pain rehabilitation programme using a combination of individual and group change data.
Methods:
A total of 261 consecutive patients attending an assessment session for the back pain rehabilitation programme completed the SF-36 health survey questionnaire. The patients were requested to complete the questionnaires again at programme completion and at the 6-month follow-up. The Reliable Change Index was used to define 'clinical significance' in terms of the assessment of individual change.
Results:
Half of those patients considered to be suitable for the programme subsequently completed it. In group terms, non-completers scored lower than completers on all SF-36 scales. Statistically significant improvements were evident for those completing the programme (all scales at P < 0.000), with improvement maintained at follow-up. In individual terms, 'clinical significance' was exceeded most frequently in the Physical Functioning and Role Physical scales. Whilst some participants lost previous improvements between completion and follow-up, others improved over this same time period. The majority of those completing the programme showed improvement in at least one scale.
Conclusions:
Adding assessment of individual change to traditional group change measures provides greater insight into the impact a rehabilitation programme has upon participants' quality of life. Whilst the programme is clearly effective for those who complete it, work is required to limit post-programme deterioration and improve uptake.
