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Effectiveness of the Godelieve Denys-Struyf (GDS) Method in People With Low Back Pain: Cluster Randomized Controlled Trial.
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- Author(s): Jose Díaz-Arribas, María; Kovacs, Francisco M.; Royuela, Ana; Fernández-Serrano, Mónica; Gutiérrez-Fernández, Lorena; San Martín-Pariente, Oscar; Abraira, Víctor; Ramos-Sánchez, Mabel; Llorca-Palomera, Rosa; Pardo-Hervás, Pedro; Gestoso, Mario; Camacho Sánchez-Gil, Gracia; Ángeles Elena-Lucas, María; Paniagua-de-la-Calle, Raquel; Castellanos-López, Isabel; Ángeles García-Heredia, María; Cerón-Sanz, Ana Miriam; Victoria-González, Basilio; Monsalve-Martín, Carmen; María Duque-Heras, José
- Source:
Physical Therapy; Mar2015, Vol. 95 Issue 3, p319-336, 18p, 2 Diagrams, 5 Charts, 1 Graph- Subject Terms:
TREATMENT of backaches; MICROWAVES; PHYSICAL therapy; ANTHROPOMETRY; CHI-squared test; CLINICAL trials; CONFIDENCE intervals; EXERCISE therapy; MEDICAL cooperation; PROBABILITY theory; REGRESSION analysis; RESEARCH; RESEARCH funding; STATISTICAL sampling; TRANSCUTANEOUS electrical nerve stimulation; STATISTICAL power analysis; PAIN measurement; BODY movement; BODY mass index; RANDOMIZED controlled trials; TREATMENT effectiveness; PRE-tests & post-tests; DATA analysis software; FUNCTIONAL assessment; DESCRIPTIVE statistics; THERAPEUTICS - Source:
- Additional Information
- Subject Terms:
- Abstract: Background. The Godelieve Denys-Struyf method (GDS) is a motor learning intervention that may be applied in group or individualized sessions. Objective. 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 [RiMQ]). 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 [Cl] = −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. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Physical Therapy is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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