Development of the movement domain in the global body examination

Norwegian Psychomotor Physiotherapy versus Cognitive Patient Education and active physiotherapy-A randomized controlled trial

BACKGROUND AND PURPOSE

Norwegian Psychomotor Physiotherapy (NPMP) has been an established treatment approach for more than 50 years, mostly in the Scandinavian countries, usually applied to patients with widespread and long-lasting musculoskeletal pain and/or psychosomatic disorders. Few studies have investigated the outcomes of NPMP, and no randomized clinical trials (RCT) with a comparing treatment group have systematically been tried out on individuals.

METHODS

This is a pragmatic, single-blinded RCT where 128 participants with long-lasting widespread musculoskeletal pain and/or pain located to the neck and shoulders were block randomized to NPMP or Cognitive Patient Education combined with active individualized physiotherapy (COPE-PT). Intention-to-treat with linear mixed models were used to estimate the group differences in treatment effects. The outcomes at 3, 6, and 12 months follow-up were pain intensity, function, anxiety and depression, quality of life, sleep, fear of movement, and subjective health complaints. Risk profile (Örebro) was examined at 3 and 6 months. All participants underwent physical tests at baseline and 6 months.

RESULTS

One-year data were available for 66.4% of the original participants. Calculated with intention-to-treat analysis, at 3 months statistically significant differences were found in favor of COPE-PT for pain, anxiety and depression, quality of life-physical dimension, risk profile and fear of movement. At 6 months, statistically significant differences in favor of COPE-PT were found for anxiety and depression, and sleep. At 12 months, the improvements were still statistically significant for anxiety, depression and sleep. Both groups improved, but no statistically significant differences were found between the groups on the physical tests at 6 months.

CONCLUSIONS

COPE-PT, which is targeted towards pain-coping and increasing activity, contribute to more improvements than NPMP.

Study protocol for Norwegian Psychomotor Physiotherapy versus Cognitive Patient Education in combination with active individualized physiotherapy in patients with long-lasting musculoskeletal pain - a randomized controlled trial

Background

Norwegian Psychomotor Physiotherapy (NPMP) has been an established treatment approach for more than 50 years, although mostly in the Scandinavian countries, and is usually applied to patients with widespread and long-lasting musculoskeletal pain and/or psychosomatic disorders. Few studies have been investigating outcome of NPMP and no randomized clinical trials (RCT) have been systematically tried out on individuals.

Methods/design

This is a study protocol for a pragmatic, single blinded RCT, which will take place in a city of Norway. The participants will be block randomized either to receive NPMP or Cognitive Patient Education in combination with active individualized physiotherapy (COPE-PT). The intervention will reflect usual care and will be conducted in physiotherapy clinics by five experienced physiotherapists in each of the two treatment approaches.

Discussion

The findings of the present study may give an important contribution to our knowledge of the outcome of NPMP, on patients with long-lasting widespread musculoskeletal pain and/or pain located to the neck and shoulder region.

Trial registration

The study has been registered with ClinicalTrials.gov (June 9 th 2015, NCT02482792).

Electronic supplementary material

The online version of this article (doi:10.1186/s12891-016-1159-8) contains supplementary material, which is available to authorized users.

Self-Reported and Tested Function in Health Care Workers with Musculoskeletal Disorders on Full, Partial or Not on Sick Leave

PURPOSE

The aim of this study was to describe self-reported and physically tested function in health care workers with musculoskeletal disorders (MSDs) and to examine how function was associated with work participation.

METHODS

A cross-sectional study was conducted. 250 health care workers attended an evaluation where self-reported and physical function were measured. Differences between groups (full sick leave, partial sick leave, not on sick leave/working) were analyzed for categorical data (Chi square exact test) and continuous variables (Kruskal-Wallis and Mann-Whitney U tests). Logistic regression analysis was performed to examine which factors were associated with being on sick leave.

RESULTS

Participants on full sick leave had statistically significant poorer function compared to those working and the group on partial sick leave. Logistic regression showed that a reduced level of the physical dimension of SF-12 and a high lift test were significantly related to full sick leave (OR 0.86, p < 0.001) (OR 0.79, p = 0.002). The physical dimension of SF-12 was the only variable that was associated to partial sick leave (OR 0.91, p = 0.005).

CONCLUSION

Health care workers on full sick leave due to MSDs have reduced function on self-reported and physically tested function, compared to those working despite MSDs, as well as when compared to those on partial sick leave. More knowledge about work ability in occupational sub-groups is needed.