The primary aim of the study is to analyse the long-term effectiveness of an interprofessional and interdisciplinary rehabilitation program named "PASTOR", with a biopsychosocial approach for participants with chronic non-specific low back pain (CLBP) compared to the standard inpatient multidisciplinary orthopaedic rehabilitation (MOR) in Germany. The investigators hypothesize that in adults with CLBP the rehabilitation program PASTOR would result in a significantly higher increase in functional ability 12 months after completion of the program in comparison to the standard inpatient MOR. The investigators further hypothesize that PASTOR would lead to significantly larger improvements regarding pain-related cognitions, pain coping strategies, physical activity, health-related quality of life, and back pain episodes compared to the standard inpatient MOR.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
536
Multidisciplinary rehabilitation includes interventions from the physical and psychological dimensions: * health education * exercise therapy * back school * physical treatments * psychological interventions in groups and individual counselling * rehabilitation/social counselling.
Interprofessional rehabilitation includes also interventions from the physical and psychological dimensions: * education about low back pain * behavioural exercise therapy * coping with pain * relaxation * work related informations
Frankenklinik
Bad Kissingen, Bavaria, Germany
Klinik Franken, Reha-Zentrum Bad Steben
Bad Steben, Bavaria, Germany
Asklepios Klinik Schaufling
Schaufling, Bavaria, Germany
University of Würzburg, Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences
Würzburg, Bavaria, Germany
Change from Baseline in Hannover Functional Ability Questionnaire (FFbH-R) at 12 months
The FFbH-R consists of twelve items with a three-stage answering scale (2=yes; 1=yes, but with difficulty; 0=no, or only with assistance). The summary score describes the low back pain associated functional ability in activities of daily living (e.g. "Can you wash and dry yourself from head to toe?") in adults on a scale of 0% (minimum functional ability) to 100% (maximum functional ability). Kohlmann Th \& Raspe H (1996). Der Funktionsfragebogen Hannover zur alltagsnahen Diagnostik der Funktionsbeeinträchtigung durch Rückenschmerzen (FFbH-R). Die Rehabilitation, 34, I-VIII.
Time frame: baseline, one year
Health-related Quality of Life (SF-12)
To assess mental and physical health status during the past four weeks. Bullinger M \& Kirchberger I (1998). SF-36, Fragebogen zum Gesundheitszustand. Göttingen: Hogrefe.
Time frame: baseline, three weeks, one year
Numerical rating scale (NRS)
Three items to assess the pain intensity reported by participants at the moment, as well as during the last six months (mean and maximum pain). Nagel B, Gerbershagen HU, Lindena G \& Pfingsten M (2002). Entwicklung und empirische Überprüfung des Deutschen Schmerzfragebogens der DGSS. Schmerz, 16 (4), 263-270.
Time frame: baseline, three weeks, one year
Freiburg Questionnaire of physical activity (FFkA)
The FQPA measures the amount of physical activity in different contexts performed by the participants: occupational setting (rating: intensive movement, moderate movement, mostly sitting) as well as leisure time physical activity (e.g. gardening, stair-climbing, habitual walking and cycling, sports). It consists of eight items. Frey I, Berg A, Grathwohl D \& Keul J (1999). Freiburger Fragebogen zur körperlichen Aktivität - Entwicklung, Prüfung und Anwendung. Sozial- und Präventivmedizin, 44, 55-64.
Time frame: baseline, one year
Pain Management Questionnaire (FESV)
Questionnaire to assess cognitive and behavioral pain coping strategies. Geissner E (2001). Fragebogen zur Erfassung der Schmerzverarbeitung (FESV). Manual. Göttingen: Hogrefe.
Time frame: baseline, three weeks, one year
Avoidance-Endurance Questionnaire (AEQ)
Questionnaire to assess fear-avoidance response pattern and avoidance-endurance response pattern to pain. Hasenbring MI, Hallner D \& Rusu AC (2009). Fear-avoidance- and endurance-related responses to pain: development and validation of the Avoidance-Endurance Questionnaire (AEQ). Eur J Pain, 13 (6), 620-628.
Time frame: baseline, three weeks, one year
Change from Baseline in Hannover Functional Ability Questionnaire (FFbH-R) at 3 weeks
The FFbH-R consists of twelve items with a three-stage answering scale (2=yes; 1=yes, but with difficulty; 0=no, or only with assistance). The summary score describes the low back pain associated functional ability in activities of daily living (e.g. "Can you wash and dry yourself from head to toe?") in adults on a scale of 0% (minimum functional ability) to 100% (maximum functional ability). Kohlmann Th \& Raspe H (1996). Der Funktionsfragebogen Hannover zur alltagsnahen Diagnostik der Funktionsbeeinträchtigung durch Rückenschmerzen (FFbH-R). Die Rehabilitation, 34, I-VIII.
Time frame: baseline, three weeks
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