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The smallest worthwhile effect of primary care physiotherapy did not differ across musculoskeletal pain sites

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • David H Christiansen
  • Nils-Bo de Vos Andersen, Central Denmark Region, Primary Health Care and Quality Improvement, Skottenborg 26, 8800 Viborg, Denmark.
  • ,
  • Per H Poulsen
  • Raymond W Ostelo, VU University, Department of Health Sciences, de Boelelaan 1081 HV, Amsterdam, Netherlands; VU University Medical Centre, Department of Epidemiology and Biostatistics and the Amsterdam Movement Sciences Research Institute, de Boelelaan 1081 HV, Amsterdam, Netherlands.

OBJECTIVES: To determine and compare estimates of the smallest worthwhile effect (SWE) for physiotherapy in neck, shoulder and low back patients, and to investigate the influence of socio-demographic, clinical and psychological factors on these estimates.

METHODS: A structured telephone interview was conducted before treatment was commenced in 160 patients referred for primary care physiotherapy. The benefit-harm trade-off method was used to estimate the SWE of physiotherapy for the following outcomes; pain, disability and time to recovery, compared with the improvement achieved without any treatment (natural course). Regression analyses were used to assess the influence of socio-demographics, clinical variables and intake scores on pain, disability and psychological scales.

RESULTS: The median SWE for improvements on pain and disability was 20% (interquartile range [IQR] 10-30%) and the SWE for time to recovery was 10 days (IQR 7-14 days) over a period of six weeks. These estimates did not differ with respect to pain location (neck, shoulder or back) and were generally unaffected by socio-demographic, clinical and psychological factors.

CONCLUSION: People with neck, shoulder and low back pain need to see at least 20% of additional improvement on pain and disability compared with natural recovery to consider that the effect of physiotherapy is worthwhile, given its costs, potential side effects and inconveniences.

OriginalsprogEngelsk
TidsskriftJournal of Clinical Epidemiology
Vol/bind101
Sider (fra-til)44-52
Antal sider9
ISSN0895-4356
DOI
StatusUdgivet - sep. 2018

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