The benefit of adding a physiotherapy or occupational therapy intervention programme to a standardized group-based interdisciplinary rehabilitation programme for patients with chronic widespread pain: a randomized active-controlled non-blinded trial

Abstract

Objective:

To evaluate the benefit of adding occupational therapy or physiotherapy interventions to a standard rehabilitation programme targeted for chronic widespread pain.

Design:

Randomized active-controlled non-blinded trial.

Subjects:

Women with chronic widespread pain recruited in a tertiary outpatient clinic.

Methods:

Participants were randomized to a two-week, group-based standard rehabilitation programme followed by 16 weeks of group-based occupational therapy (Group B_OT, n = 43) or 16 weeks of group-based physiotherapy (Group B_PT, n = 42). Group A only received the two-week rehabilitation programme acting as comparator (n = 96).

Outcomes:

Primary outcomes were the Assessment of Motor and Process Skills and Short Form-36 (SF36) Mental Component Summary score.

Results:

Mean changes in motor and process ability measures were clinically and statistically insignificant and without differences across the three groups assessed 88 weeks from baseline. Motor ability measures: −0.006 (95% confidence interval (CI): −0.244 to 0.233) in Group B_OT; −0.045 (95% CI: −0.291 to 0.202) in Group B_PT; and −0.017 (95% CI: −0.248 to 0.213) in Group A, P = 0.903. Process ability measures: 0.087 (95% CI: −0.056 to 0.231) in Group B_OT; 0.075 (95% CI: −0.075 to 0.226) in Group B_PT; and 0.072 (95% CI: −0.067 to 0.211) in Group A, P = 0.924. Mean changes in patient-reported outcomes were likewise small; clinically and statistically insignificant; and independent of group allocation, except for the SF36 mental component summary score in the B_PT group: 8.58 (95% CI: 1.75 to 15.41).

Conclusion:

Participants were on average stable in observation-based measures of functional ability and patient-reported outcomes, except in overall mental well-being, favouring the enhanced intervention. Efficacy of additional interventions on functional ability remains uncertain.

Keywords

Chronic widespread pain physiotherapy occupational therapy activities of daily living rehabilitation

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