Physiotherapeutic acute low back pain interventions in the private health sector of the Cape Metropole, South Africa.

Abstract

Objective: To  rigorously  evaluate  the  outcomes  of  physio-therapeutic interventions in patients with acute low back pain (LBP) within a clinical context.Methods:  A  multi-centre  prospective  case-series  study  design  was  used.  Eight private physiotherapy practices within the Cape Metropole, Cape Town, South Africa, each screened and recruited 12 eligible patients with acute LBP. Main outcome measures included pain and functional status.Data analysis: Demographic information, as well as pain and disability scores were descriptively analyzed using means, standard deviations and confidence intervals. The percentage change in pain was determined by the formula (100*painvisit2-painvisit1/painvisit1) and the significance level was set at p=0.05. Forward stepwise logistic regression was conducted to determine predictors of good pain and disability outcomes.Results: 48 subjects with acute LBP participated in this study (24 male and 24 female; mean age was 41.65 (SD 13.34). All scores except pain scores in the previous week, significantly improved (P<0.05). For disability, the difference between all visits bar the 10th visit was significant. No significant predictors for pain and disability for the final pain and disability score were found (crude odds calculations).Conclusion:  The  study  illustrates  that  physiotherapy  management  interventions  based  on  the  interpretation of  individual  physiotherapists  in  a  real-life  scenario,  yield  positive  outcomes  with  respect  to  momentary  pain  and  disability  scores.  With  over  27  different  combinations  of  treatment  modalities  used  across  the  participating  practices, conclusions as to the most effective physiotherapy treatment regimens for acute episodes of non-specific LBP in private practice cannot be made.