Individual Versus Group Physical Therapy for Patients with Low Back Pain: Outcomes and Process (Therapeutic Factors)

ABSTRACT

Low back pain (LBP) is a common health problem usually treated individually, and requires costly physical therapy. Group treatment, besides being cost-effective, provides psychological support to the recovery of people who struggle with a physically disabling condition. The current study compares individual and group treatment of LBP, measuring differences in outcomes and process data (therapeutic factors). The study included 158 patients who participated in group (n = 71) and individual (n = 87) physical therapy, using a pre-post-follow-up design. Results indicated a significant improvement in all outcome measures at postintervention in both treatment settings, with no difference between them, which were sustained at follow-up. On a clinical level, a few differences were found: At postintervention, minimal clinically important improvement in perceived functioning and level of pain was greater among patients treated individually. On the other hand, at follow-up, only group participants gained additionally in perceived functioning and in fear avoidance. Therapeutic factors of other- versus self-focus and problem definition–change were more prevalent in group treatment.

ACKNOWLEDGMENTS

The authors thank the physical therapists from Maccabi Health Services who assisted in data collection, and statistician Dr. Edna Gutman for her assistance in statistical analysis. The study was approved by the Maccabi Healthcare Services Institutional Review Board for the Protection of Human Subjects, Institute. The study protocol was registered in the Clinical Trials Registry of Israel Institute of Health (Clinical Trials.gov Identifier: NCT02138071).

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author.

Additional information

Notes on contributors

Ofra Netzer

Ofra Netzer is the head of physiotherapy clinic at Maccabi Healthcare Services, Zikhron-Ya'acov, Israel. Zipora Shechtman is a professor of Counseling and Human Development at Haifa University, Haifa, Israel.