The Effect of Long-Term Body Awareness Training Succeeding a Multimodal Cognitive Behavior Program for Patients with Widespread Pain
ABSTRACT Objectives: Multimodal cognitive behavior programs are found to be appropriate treatment for patients with chronic widespread pain [CWP]. The aim of this study was to investigate whether follow-up body awareness group training could cause a greater long-lasting effect and promote more patients to return to work. Methods: In a randomized controlled trial, 52 patients with CWP and more than 10 tender points were enrolled after having participated in a multimodal program. The intervention group attended a psychomotor physiotherapy group training 18 times during 1.5 years. The training started one month after the end of multimodal treatment. The control group received treatment as usual. Outcome measures were work status, Global Physiotherapeutic Examination, pain levels, and quality of life. All patients were tested within two weeks after the multimodal treatment, after 12 months, and after 18 months. Results: Improvement in test scores was demonstrated in both groups over time. However, the intervention group demonstrated fewer tender points and a reduced distribution of pain. After one year, two-thirds of the intervention group and one-third of the control group was back at work, while after 1.5 years the difference between groups was less and not statistically significant. Conclusions: Improvement over time was obtained for all patients who had participated in the multimodal program. Indication was provided that follow-up psychomotor physiotherapy based on body awareness training might cause additional improvement of symptoms and a higher rate of return to work. The research question should be further examined in randomized controlled trial studies providing similar baseline data between participating groups.