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Original article

Vol. 147 No. 1920 (2017)

Effectiveness of the Bern Ambulatory Interprofessional Rehabilitation (BAI-Reha) programme for patients with chronic musculoskeletal pain: a cohort study

DOI
https://doi.org/10.4414/smw.2017.14433
Cite this as:
Swiss Med Wkly. 2017;147:w14433
Published
08.05.2017

Summary

QUESTIONS UNDER STUDY

Chronic pain has a high impact on individuals and society. (Cost-)effective interventions are desperately needed. We evaluated short- and long-term effects of the Bern Ambulatory Interprofessional Rehabilitation (BAI-Reha) for patients with chronic musculoskeletal pain.

METHODS

We analysed data prospectively collected from patients with chronic musculoskeletal pain before and after BAI-Reha (at 12 weeks, 1 year and 2 years) using linear mixed-models and logistic generalised estimating equations.

RESULTS

The first thirty consecutive patients with chronic musculoskeletal pain, aged between 20 and 73 years (mean 44.83, standard deviation 12.57 years) were included. We found significant changes over time compared with baseline for return to work (p <0.001), Euro quality of life visual analogue scale score (p = 0.026), burden of suffering (p = 0.001), self-rated and observed quality of daily life task motor performance (p <0.001 and p = 0.012, respectively) but not for pain intensity (p = 0.16) and observed quality of daily life task process performance (p = 0.28). At the first postintervention visit we found significant differences compared with baseline in return to work (odds ratio 5.26, 95% confidence interval [CI] 1.80–15.39], burden of suffering (mean difference 5.26, 95% CI 2.09–8.44], self-rated quality (mean difference 2.31, 95% CI 1.57–3.05) and satisfaction (mean difference 2.80, 95% CI 1.95-3.66) with daily life task performance, and observed quality with daily life task motor performance (mean difference 0.31, 95% CI 0.02–0.60).

CONCLUSIONS

This study confirms earlier data and supports the effectiveness of interprofessional rehabilitation for patients with chronic musculoskeletal pain.

References

  1. Wieser S, et al. Die Kosten der nichtübertragbaren Krankheiten in der Schweiz. Bern: Bundesamt für Gesundheit; 2014.
  2. Hoving JL, van Zwieten MC, van der Meer M, Sluiter JK, Frings-Dresen MH. Work participation and arthritis: a systematic overview of challenges, adaptations and opportunities for interventions. Rheumatology (Oxford). 2013;52(7):1254–64. https://doi.org/10.1093/rheumatology/ket111
  3. Wolf LD, Davis MC. Loneliness, daily pain, and perceptions of interpersonal events in adults with fibromyalgia. Health Psychol. 2014;33(9):929–37. https://doi.org/10.1037/hea0000059
  4. Waehrens EE, Amris K, Fisher AG. Performance-based assessment of activities of daily living (ADL) ability among women with chronic widespread pain. Pain. 2010;150(3):535–41. https://doi.org/10.1016/j.pain.2010.06.008
  5. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al.; COST B13 Working Group on Guidelines for Chronic Low Back Pain. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(S2, Suppl 2):S192–300. https://doi.org/10.1007/s00586-006-1072-1
  6. Kjeken I, Bø I, Rønningen A, Spada C, Mowinckel P, Hagen KB, et al. A three-week multidisciplinary in-patient rehabilitation programme had positive long-term effects in patients with ankylosing spondylitis: randomized controlled trial. J Rehabil Med. 2013;45(3):260–7. https://doi.org/10.2340/16501977-1078
  7. Jensen IB, Bergström G, Ljungquist T, Bodin L. A 3-year follow-up of a multidisciplinary rehabilitation programme for back and neck pain. Pain. 2005;115(3):273–83. https://doi.org/10.1016/j.pain.2005.03.005
  8. Martín J, Torre F, Aguirre U, González N, Padierna A, Matellanes B, et al. Evaluation of the interdisciplinary PSYMEPHY treatment on patients with fibromyalgia: a randomized control trial. Pain Med. 2014;15(4):682–91. https://doi.org/10.1111/pme.12375
  9. Castel A, Fontova R, Montull S, Periñán R, Poveda MJ, Miralles I, et al. Efficacy of a multidisciplinary fibromyalgia treatment adapted for women with low educational levels: a randomized controlled trial. Arthritis Care Res (Hoboken). 2013;65(3):421–31. https://doi.org/10.1002/acr.21818
  10. Casanueva-Fernández B, Llorca J, Rubió JB, Rodero-Fernández B, González-Gay MA. Efficacy of a multidisciplinary treatment program in patients with severe fibromyalgia. Rheumatol Int. 2012;32(8):2497–502. https://doi.org/10.1007/s00296-011-2045-1
  11. Lemstra M, Olszynski WP. The effectiveness of multidisciplinary rehabilitation in the treatment of fibromyalgia: a randomized controlled trial. Clin J Pain. 2005;21(2):166–74. https://doi.org/10.1097/00002508-200503000-00008
  12. Monticone M, Ferrante S, Rocca B, Baiardi P, Farra FD, Foti C. Effect of a long-lasting multidisciplinary program on disability and fear-avoidance behaviors in patients with chronic low back pain: results of a randomized controlled trial. Clin J Pain. 2013;29(11):929–38. https://doi.org/10.1097/AJP.0b013e31827fef7e
  13. Monticone M, Ambrosini E, Rocca B, Magni S, Brivio F, Ferrante S. A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study. Eur Spine J. 2014;23(10):2105–13. https://doi.org/10.1007/s00586-014-3478-5
  14. Nazzal ME, Saadah MA, Saadah LM, Al-Omari MA, Al-Oudat ZA, Nazzal MS, et al. Management options of chronic low back pain. A randomized blinded clinical trial. Neurosciences (Riyadh). 2013;18(2):152–9.
  15. Dufour N, Thamsborg G, Oefeldt A, Lundsgaard C, Stender S. Treatment of chronic low back pain: a randomized, clinical trial comparing group-based multidisciplinary biopsychosocial rehabilitation and intensive individual therapist-assisted back muscle strengthening exercises. Spine. 2010;35(5):469–76. https://doi.org/10.1097/BRS.0b013e3181b8db2e
  16. Henchoz Y, de Goumoëns P, So AK, Paillex R. Functional multidisciplinary rehabilitation versus outpatient physiotherapy for non specific low back pain: randomized controlled trial. Swiss Med Wkly. 2010;140:w13133. https://smw.ch/en/archives/article/?tx_ezmjournal_articledetail[identifier]=smw.2010.13133
  17. Lemstra M, Stewart B, Olszynski WP. Effectiveness of multidisciplinary intervention in the treatment of migraine: a randomized clinical trial. Headache. 2002;42(9):845–54. https://doi.org/10.1046/j.1526-4610.2002.02202.x
  18. Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ, Ostelo RW, Guzman J, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain. Cochrane Database Syst Rev. 2014;(9):CD000963. doi:.https://doi.org/10.1002/14651858.CD000963.pub3
  19. Artus M, van der Windt D, Jordan KP, Croft PR. The clinical course of low back pain: a meta-analysis comparing outcomes in randomised clinical trials (RCTs) and observational studies. BMC Musculoskelet Disord. 2014;15(1):68. https://doi.org/10.1186/1471-2474-15-68
  20. World Health Organisation. ICD-10. Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme. 10. Revision. Köln: Deutschen Institut für Medizinische Dokumentationund Information; 2013.
  21. EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199–208.
  22. EuroQol Group. EQ-5D-3L User Guide. Basic information on how to use the EQ-5D-3L instrument. Rotterdam: EuroQoL Group; 2013. p. 199–208.
  23. Cleland JA, Childs JD, Whitman JM. Psychometric properties of the Neck Disability Index and Numeric Pain Rating Scale in patients with mechanical neck pain. Arch Phys Med Rehabil. 2008;89(1):69–74. https://doi.org/10.1016/j.apmr.2007.08.126
  24. Fisher AG, Jones KB. Assessment of Motor and Process Skills: Development, standardization, and administration manual. 7th Revised ed. Vol. I. Fort Collins, CO: Three Star Press; 2012.
  25. Law M, et al. COPM. Canadian Occupational Performance Measure. 4th ed. Idstein: Schulz-Kirchner Verlag GmbH; 2009.
  26. Streffer ML, Büchi S, Mörgeli H, Galli U, Ettlin D. PRISM (pictorial representation of illness and self measure): a novel visual instrument to assess pain and suffering in orofacial pain patients. J Orofac Pain. 2009;23(2):140–6.
  27. Obradovic M, Lal A, Liedgens H. Validity and responsiveness of EuroQol-5 dimension (EQ-5D) versus Short Form-6 dimension (SF-6D) questionnaire in chronic pain. Health Qual Life Outcomes. 2013;11(1):110. https://doi.org/10.1186/1477-7525-11-110
  28. Gantschnig BE, Page J, Fisher AG. Cross-regional validity of the assessment of motor and process skills for use in middle Europe. J Rehabil Med. 2012;44(2):151–7. https://doi.org/10.2340/16501977-0915
  29. Weidt S, Bruehl AB, Moergeli H, Straumann D, Hegemann S, Büchi S, et al. Graphic representation of the burden of suffering in dizziness patients. Health Qual Life Outcomes. 2014;12(1):184. https://doi.org/10.1186/s12955-014-0184-2
  30. Kassardjian CD, Gardner-Nix J, Dupak K, Barbati J, Lam-McCullock J. Validating PRISM (Pictorial Representation of Illness and Self Measure) as a measure of suffering in chronic non-cancer pain patients. J Pain. 2008;9(12):1135–43. https://doi.org/10.1016/j.jpain.2008.06.016
  31. UNESCO Institute for Statistics. International Standard Classification of Education. ISCE 2011. Montreal: UNESCO Institute for Statistics; 2012.
  32. Hoving JL, Lacaille D, Urquhart DM, Hannu TJ, Sluiter JK, Frings-Dresen MH. Non-pharmacological interventions for preventing job loss in workers with inflammatory arthritis. Cochrane Database Syst Rev. 2014;(11):CD010208. doi:.https://doi.org/10.1002/14651858.CD010208.pub2
  33. Drummond MF, et al. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford: Oxford University Press; 2005.
  34. Verra ML, Angst F, Brioschi R, Lehmann S, Benz T, Aeschlimann A, et al. Effectiveness of subgroup-specific physiotherapy: a randomized controlled trial with one-year follow up in persons with chronic back pain. Physiotherapy. 2015;101(Supplement 1):e1586–7. https://doi.org/10.1016/j.physio.2015.03.1592
  35. Wæhrens EE. Measuring quality of occupational performance based on self-report and observation. Development and validation of instruments to evaluate ADL task performance, in department of community medicine and rehabilitation, occupational therapy. Umeå: Umeå University Press; 2010.
  36. Amris K, Wæhrens EE, Christensen R, Bliddal H, Danneskiold-Samsøe B ; IMPROvE Study Group. Interdisciplinary rehabilitation of patients with chronic widespread pain: primary endpoint of the randomized, nonblinded, parallel-group IMPROvE trial. Pain. 2014;155(7):1356–64. https://doi.org/10.1016/j.pain.2014.04.012

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