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Moreover, the SNHS provides free health care to every resident in Spain, physical therapy practice is largely consistent across different areas, and experimental physical therapy protocols are standardized. The perception that the GDS is a new treatment may have triggered a more powerful placebo effect or greater adherence of participants, as suggested by the fact that the number of participants failing to attend the physical vadenas sessions was larger in the control group.

Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: At 12 months, disability improved 0.

Classification of Chronic Pain: Intraclass correlation coefficients at the participant and cluster levels are shown in Table 4. I agree to the terms and conditions. Moreover, the available evidence shows that their effect—if any—is minimal for LBP and even smaller for disability.

Participants completed all of the self-administered questionnaires on their own, unaccompanied by health care staff or third parties, but they could ask the assessors questions. The results of the present study suggest that group sessions of the GDS improved disability but not pain slightly more than the physical therapy treatment routinely used within the SNHS, even when participants in both groups GDS-G and control were benefiting from an muscualres education program.

Email alerts New issue alert. As is the case with other physical therapy methods in which muculares assessment process is used to establish subgroups of patients with LBP, 58 — 62 in GDS-I, classification determines the specific treatment to be applied. In this fds randomized trial, treatment allocation, participants’ assessments, and statistical analyses were masked, and statistical methods were used to adjust results for potential confounders.


Treatments considered to be musculzres or alternative, such as acupuncture or homeopathy, were not registered as cointerventions in the present study. Time-dependent surgical outcomes following cauda equina syndrome diagnosis: Assessors attended the physical therapy units only when participants had been scheduled for assessment and were never present when the treatments were applied.

In the control group, among the 1, possible session attendees participants attending 15 sessionsthere were absences 9. The amount of exercise was smaller in the control group, and GDS-I sessions were provided by junior physical therapists.

Real-world practice patterns, health-care utilization, and costs in patients with low back pain: Practitioners of the GDS assume that the most shortened muscle chain in a given patient is the one that should be specifically treated and should be identified as the one that is most restrictive of the movement of antagonists when not opposed to gravity.

The Godelieve Denys-Struyf method GDS is a motor learning intervention that may be applied in group or individualized sessions. Clinical course of pain and disability across groups. Assessors were 12 physical therapist students, who were not linked to the physical therapy units and who had no contact with the clinical staff at the units or the rest of the research staff, except for the study coordinator.

Alex Alvarez

The variables that remained as confounders in the models were as follows: These assumptions were based on previous studies assessing physical muscullares treatments for LBP within the primary care centers of the SNHS and on clinically relevant minimal changes in pain and disability. Outcome measures for low back pain research: This trial was conducted only with people referred to physical therapists.

Data are reported as number percentage unless otherwise indicated. Intracluster Correlations Estimated by Regression Models a. Effectiveness of the physical therapy Godelive Denys-Struyf method for nonspecific low back pain: Surgery versus conservative management of sciatica due to a lumbar herniated disc: Variables that remained as confounders in the models were as follows: This idea should be explored in future studies. Because the cluster design increases the risk of baseline characteristics being unbalanced across treatment groups, 44 potential confounders were defined both clinically and by unbalance across groups at baseline Tab.


Minimal clinically important change for pain intensity and disability in patients with nonspecific low back pain. Physical therapy units and participants were introduced as random effects. The results of the present study are generally consistent with those of previous studies on the effect of motor control exercise.

However, there was virtually no correlation between musculwres participants treated within each physical therapy unit 1. Non-specific low back pain in primary care in the Spanish National Health Service: Those providing the GDS group sessions had attended a hour course offered by a GDS-certified senior physical therapist.

You must accept the terms and conditions. Consultation including review of the manuscript before submission: Thank you for submitting a comment on this article. Receive exclusive offers and updates from Oxford Academic. Centered baseline scores were included as covariates in each model.

The improvement in disability was slightly higher with group GDS sessions than with the program routinely used in clusters within the SNHS. A coordination office prepared consecutively numbered, opaque, sealed envelopes, each containing a number extracted from a random numbers table.

No adverse events were reported by any participant in any group. Randomized Controlled Trials Subject: Physical Component Summary of SF d. Assessors had been told that they were going to assess the clinical course of participants undergoing physical therapy but not that different types of physical therapy were being compared.