AlphaCare (Rehab) Ltd



references



1). Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial. {BMJ,doi:10.1136/bmj.38441.620417.BF (published 23 May 2005)}

“A total of 349 patients were randomised between June 1996 and February 2002 from 15 centres in the UK (176 allocated to surgery and 173 to rehabilitation).
Rehabilitation including a cognitive behaviour approach is not routinely or widely available to patients with chronic pain of the low back and this trial implies that it should be.
Evidence is moderate to strong that multidisciplinary rehabilitation including general exercise programmes of muscle strengthening, flexibility training and cardiovascular endurance along with a cognitive behaviour approach improves function, reduces pain and work loss in patients with chronic pain of the low back compared with usual care or non multidisciplinary treatment. This type of treatment…….is not routinely available in the NHS.”


2). European Guidelines for the Management of non specific low back pain.
{November 2005}

“This particular guideline intends to foster a realistic approach to improving the treatment of non specific chronic low back pain by:

  • providing recommendations on strategies to manage chronic low back pain
  • ensuring an evidence based approach through the use of systematic reviews and existing evidence based guidelines
  • providing recommendations that are generally acceptable to a wide range of professionals
  • enabling a multidisciplinary approach
  • identifying ineffective interventions to limit their use
  • highlighting areas where more research is needed.

True multidisciplinary treatment programs have to include medical (pharmacological treatment, education), physical (exercise), vocational and behavioural components and have to be provided at least by three health care professionals with different clinical backgrounds (physician, physiotherapist, psychologist)
There is strong evidence that intensive multidisciplinary biopsychosocial rehabilitation with a functional restoration approach reduces pain and improves function in patients with chronic low back pain.
There is strong evidence that intensive multidisciplinary biopsychosocial interventions are effective in terms of return to work”.


3). Multidisciplinary bio-psychosocial rehabilitation for chronic back pain.
{Guxman J, Esmail R, Karjalainen K, Malmivaara A, Irvin E, Bombardier C, Cochrane Review 2001}

Ten trials randomised 1964 patients with low back pain of 13 weeks or more duration and were of working age.
The reviewed studies provide evidence that intensive (> 100 hours of therapy) multidisciplinary biopsychosocial rehabilitation with a functional restoration approach produces greater improvements in pain and function in patients with disabling chronic low back pain than non multidisciplinary rehabilitation or usual care. Less intensive treatments did not seem effective.”