OBJECTIVE: To assess the effectiveness of a single session of education and exercise compared with multiple sessions of a multimodal physiotherapy intervention for adults with spinal disorders in an advanced practice physiotherapy specialized spine model of care. DESIGN: Pragmatic randomized controlled trial. METHODS: We randomized patients with spinal disorders, who were referred for a spinal surgery consultation and triaged as nonsurgical cases by an advanced practice physiotherapist, to a single session of education and prescription of an exercise program (n = 52) or multiple sessions (6 in total) of a multimodal physiotherapy intervention (n = 54). The primary outcomes were the short form Brief Pain Inventory pain severity scale (BPI-S) and the Brief Pain Inventory pain interference scale (BPI-I), and secondary outcomes included disability, quality of life, catastrophization, and satisfaction. Linear mixed models were used to assess differences between groups across time points at 6, 12, and 26 weeks. RESULTS: There were no significant between-group differences on the BPI-S and only a significant improvement at 6 weeks on the BPI-I in the multiple-session group (mean difference: -0.96/10; 95% CI, -1.87 to -0.05). There were no other statistically significant differences between groups, except for satisfaction where participants in the multiple-session group reported statistically significantly greater satisfaction on the 9-item Visit-Specific Satisfaction Questionnaire and the MedRisk questionnaire. Both groups saw significant improvements over time on all outcomes except for the BPI-S. CONCLUSION: Adding supervised multimodal physiotherapy sessions did not result in better clinical outcomes when compared to a single session of education and exercise. Patients were more satisfied with the multiple-session approach. J Orthop Sports Phys Ther 2024;54(10):1-13. Epub 9 September 2024. doi:10.2519/jospt.2024.12618.
| Discipline Area | Score |
|---|---|
| Rehab Clinician (OT/PT) |  |
Rehab Clinician (OT/PT) rater
This study may potentially change our current practice.
Rehab Clinician (OT/PT) rater
The implications of this research are clear in that advanced practice physiotherapy specialized spine care models can be effective with a single session however, and not surprisingly, follow-up sessions enhance patient satisfaction. These findings could be used to develop similar research in many other conditions where multiple sessions have become the norm as a treatment option.
Rehab Clinician (OT/PT) rater
An important comment in the conclusion of this study appears worthy of attention, one that was omitted in the abstract: "The study population included mostly older adults with chronic conditions, with a moderate-to-high risk of poor outcomes, and who were initially referred for a consultation in spine surgery. Therefore, generalization to different populations should be made carefully."
, McMaster University