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Comparative effectiveness of supervised individual, group-based, and mixed physiotherapy approaches on pain and
Romualdo Ordónez Vega1, Iván Cuyul-Vásquez2,3, Marco Morales Osorio4
1Centro de Salud Familiar San Vicente, Sala de Rehabilitación Física, Talcahuano, Chile.
Background:
It remains unclear whether clinical outcomes from group-based physiotherapy are comparable to individual sessions, or if a mixed approach yields superior results in primary care. This study aimed to compare the effectiveness of supervised individual, group-based, and mixed physiotherapy approaches on pain and function in patients with chronic pain in primary care setting.
Methods:
In this retrospective observational study, clinical records were analyzed for 124 patients (mean age 58.6 ± 12.4 years) with chronic pain (duration > 6 months). Patients received supervised individual (n = 55), group-based (n = 38), or mixed (n = 31) physiotherapy. The outcome measures assessed pre- and post-intervention were physical function, pain intensity, and perception of change.
Results:
No significant between-group differences were observed in any outcome measure at post-intervention (p > .05). Conversely, a significant main effect of time was observed across all outcome measures in the three intervention groups (p < .001). Statistically significant improvements were observed in all three groups for physical function (individual: ∆ = 3.1 points, p < .001, d = 1.31; group-based: ∆ = 2.7 points, p < .001, d = 1.16; mixed: ∆ = 2.7 points, p < .001, d = 1.24). Similarly, a statistically significant decrease in pain intensity was observed in all groups, with a medium to large effect sizes and changes that exceeded the Minimally Clinically Important Difference (MCID) (individual: ∆ = -3.6 points, p < .001, d = -1.14; group-based: ∆ = -3.6 points, p < .001, d = -1.44; mixed: ∆ = -2.3 points, p < .001, d = -0.70). The perception of change also exceeded the MCID in all groups (individual: ∆ = 4.0 points; group-based: ∆ = 4.1 points; mixed: ∆ = 4.1 points).
Conclusions:
In a primary care setting, supervised individual, group-based, and mixed physiotherapy interventions demonstrated comparable clinical effectiveness in reducing pain and improving physical function in patients with chronic musculoskeletal pain. Future randomized controlled trials with adequate follow-up periods are needed to validate these results.