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Effectiveness of the Physical Therapy Godelive Denys-Struyf Method for Nonspecific Low Back Pain: Primary Care Randomized Control Trial

Arribas, María José Díaz PhM*; Sánchez, Mabel Ramos MD*; Hervás, Pedro Pardo MD*; Chicharro, José López MD; Carreré, Teresa Angulo MD; Molina, Paloma Ortega MD; Arbiza, Paloma Astasio MD

doi: 10.1097/BRS.0b013e3181aa2771
Randomized Trial

Study Design. A simple blind, random controlled clinical trial.

Objective. To assess the effectiveness of physiotherapy treatment based on the muscular and articular chains Godelive Denys-Struyf (GDS) method for nonspecific low back pain (LBP) in primary care.

Summary of Background Data. Despite a systematic review by the European COST ACTION B13 “Low back pain: guidelines for its management,” there are still many unresolved questions regarding the effectiveness of the different physical therapy treatments used for LBP. Setting: 21 physicians and physiotherapists in 7 Primary Care Centers and 6 researches in the Complutense University of Madrid (Spain). Participants: 137 patients diagnosed with nonspecific LBP.

Methods. The control group underwent 15 sessions of conventional physiotherapy in Primary Care Centers, and the experimental group received 15 GDS treatment sessions. Pain was evaluated by Visual Analogical Scale (VAS), functional disability by Oswestry questionnaire, and quality of life by the physical and mental components of SF-36 questionnaire. Outcome measures were assessed before treatment (A1), at the end of treatment (A2), and at 3 months (A3), and 6 months (A4) of follow-up.

Results. Repeated measures analysis of variance revealed that at the end of treatment and 3 months later, subjects in both groups showed less pain, reduced functional disability, and an improved quality of life, though improvements were greater in the GDS group.

Six months after treatment, patients in the GDS group continued to show reduced pain (VAS(A4–A1) = −3.54, 95% CI: −4.18 to −2.90) while VAS scores in the control group returned to initial values (VAS(A4–A1) = 0.15, 95% CI: −0.36 to 0.67).

Conclusion. Treatment of nonspecific LBP using the GDS method provides greater improvements in the midterm (6 months) in terms of the pain, functional ability, and quality of life perceived by patients than the conventional treatment based administered in primary care.

The findings of this random controlled clinical trial suggest that the use of the Godelive Denys-Struyf physical therapy method to treat nonspecific low back pain leads to greater improvements after treatment in patient perceived pain, functional ability, and quality of life than the conventional treatment used in Spanish primary care.

From the *Department of Physical Medicine and Rehabilitation, Complutense University of Madrid, Madrid, Spain; †University School of Physical Therapy, Complutense University of Madrid, Madrid, Spain; and ‡Department of Preventive Medicine and Public Health, Complutense University of Madrid, Madrid, Spain.

Acknowledgment date: October 31, 2008. Revision date: January 19, 2009. Acceptance date: February 3, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Funded by Spanish National Institute of Health (NIH).

Spanish Trial registration: FIS-PI051650. Available at: http://www.isciii.es/htdocs/investigacion/convocatorias/pdf/LA2007PISINISCIII.pdf.

Address correspondence and reprint requests to María José Díaz Arribas, PhM, Department of Physical Medicine and Rehabilitation, Complutense University of Madrid, Madrid, Spain; E-mail: mjdiazar@med.ucm.es

© 2009 Lippincott Williams & Wilkins, Inc.