PT  - JOURNAL ARTICLE
AU  - Joanna E Surtees
AU  - N R Heneghan
TI  - General group exercise in low back pain management in a military population, a comparison with specific spine group exercise: a service evaluation
AID  - 10.1136/jramc-2018-001011
DP  - 2020 Jun 01
TA  - BMJ Military Health
PG  - 140--145
VI  - 166
IP  - 3
4099  - http://militaryhealth.bmj.com/content/166/3/140.short
4100  - http://militaryhealth.bmj.com/content/166/3/140.full
SO  - BMJ Mil Health2020 Jun 01; 166
AB  - 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.