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General group exercise in low back pain management in a military population, a comparison with specific spine group exercise: a service evaluation
  1. Joanna E Surtees1 and
  2. N R Heneghan2
  1. 1 Primary Care Rehabilitation Facility, RAF Waddington, Lincoln, UK
  2. 2 Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, College of Life and Environmental Sciences, Birmingham, UK
  1. Correspondence to Dr N R Heneghan, Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK; n.heneghan{at}


Objective To investigate whether general group exercise (GGE) offers the same outcomes compared with a specific spinal group exercise (SSGE) for chronic low back pain (CLBP) in a military population.

Design Retrospective service evaluation using routine service activity data.

Setting A UK military rehabilitation centre.

Participants A total of 106 patients with CLBP.

Interventions Three-week intensive (5 days per week, 15-day intervention) rehabilitation course for patients with CLBP. Six SSGE groups (n=64); CLBP only. Six GGE groups (n=42); CLBP patients grouped with chronic lower limb (LL) injuries.

Outcome measures Oswestry Disability Index (ODI), Numerical Pain-Rating Scores and the Modified Multi-Stage Fitness Test (Mod-MSFT). Long-term effects were measured by Medical Employment Standard (MES) status and physiotherapy follow-up at 3 and 12 months.

Results A between-group analysis showed no significant difference in GGE compared with SSGE. Mean changes (SD) in pain were −2.71±2.35 and −1.20±1.99 (p=0.018), ODI were −3.6±5.7 and −4±8.5 respectively (p=0.649) and Mod-MSFT 28.4±30.8 and 29.7±31.7 respectively (p=0.792). At 3 months, a greater proportion of the GGE were having ongoing physiotherapy; GGE=50%, SSGE=30.2%, (p=0.016) although some differences were evident across MES with 32.5 % of GGE compared with 20.6 % of SSGE being medically fit with no restrictions. At 12 months, groups were largely comparable for follow-up physiotherapy and MES; 22.5% of GGE and 20.6% of SSGE continued to have physiotherapy input; 47.5% of GGE and 50.8% of SSGE were medically fit with no restrictions.

Conclusion Patients with CLBP who completed a 3-week rehabilitation programme had comparable outcomes when grouped with patients with LL, although only improvements in pain in the GGE group achieved a meaningful change. Further evaluation of potential costs and savings to service costs is now required.

  • chronic low back pain
  • group therapy
  • exercise
  • service evaluation

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  • Contributors JS and NRH: service evaluation design, analysis and manuscript development. JS: data extraction and analysis.

  • Funding The author received no specific grant from any funding agency in the commercial, public or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham.

  • Provenance and peer review Not commissioned; externally peer reviewed.