Article

The Godelieve Denys-Struyf method (GDS) is a motor learning
intervention that may be applied in group or individualized sessions.
The study objective was to compare the effectiveness of routine physical therapy,
group GDS (GDS-G) sessions, and group and individualized GDS (GDS-I) sessions.
DESIGN: This was a cluster randomized controlled trial. SETTING: The study took
place in 21 primary care physical therapy units ("clusters") of the Spanish
National Health Service (SNHS). PARTICIPANTS: The participants were 461 people
with subacute and chronic low back pain (LBP). INTERVENTION: Clusters were
randomized into 3 groups. All participants received medical treatment and a
15-minute group education session on active management. Additional interventions
were as follows: control (fifteen 40-minute sessions of transcutaneous electrical
nerve stimulation, microwave treatment, and standardized exercises), GDS-G
(eleven 50-minute group GDS sessions), and GDS-I (the same 11 sessions plus four
50-minute individualized GDS sessions). MEASUREMENTS: Primary outcomes at
baseline and 2, 6, and 12 months later were LBP and pain referred down the leg
(separate pain intensity numeric rating scales) and disability (Roland-Morris
Questionnaire [RMQ]). Secondary outcomes were use of medication and self-reported
health (mental and physical component summaries of the 12-Item Short-Form Health
Survey [SF-12]). Separate linear mixed models for LBP, pain referred down the
leg, and disability were developed to adjust for potential confounders.
Randomization, outcome assessment, and data analyses were masked. RESULTS: At 12
months, disability improved 0.7 (95% confidence interval [CI]=-0.4, 1.8) RMQ
point in the control group, 1.5 (95% CI=0.4, 2.7) RMQ points in the GDS-I group,
and 2.2 (95% CI=1.2, 3.2) RMQ points in the GDS-G group. There were no
differences in pain. LIMITATIONS: The amount of exercise was smaller in the
control group, and GDS-I sessions were provided by junior physical therapists.
CONCLUSIONS: The improvement in disability was slightly higher with group GDS
sessions than with the program routinely used in clusters within the SNHS. Adding
individualized GDS sessions eliminated this advantage. Further studies should
compare the GDS with other types of exercise.
CI - (c) 2015 American Physical Therapy Association.

Langue : ANGLAIS