Patient-Reported Outcomes for Low Back Pain Patients After Structured Education & Exercise Program (GLA:D Back)

Lumbar spinal stenosis (LSS) is a common condition experienced by older adults, and often seen in primary care settings. Like non-specific low back pain (NS-LBP), most people with LSS can be managed with interventions including patient education and exercise. Although they may not have received a definitive diagnosis of LSS, many people seeking care for NS-LBP may also be experiencing symptoms of LSS.
 
In this study, the authors examined whether primary care patients with LSS symptoms may benefit from programs designed for patients with NSLBP, or whether they might need more specific interventions.
 
One such intervention is GLA:D back, a program designed for people with NS-LBP that includes education and exercise therapy aimed at improving the self-management of LBP. Additionally, GLA:D back has a unique feature of a patient registry, which can provide researchers with data to evaluate how GLA:D back works for people with NS-LBP and LSS symptoms. In previous studies, 71% of participants in the GLA:D back program report “sometimes experiencing numbness or pain in their buttocks or legs” that is commonly experienced in LSS patients. GLA:D back participants also reported 11-58% prevalence of other LSS symptoms, but no previous studies have examined the program’s impact on LSS symptoms.
 
Thus, the authors’ intent was to evaluate whether the GLA:D back program differed in outcomes related to disability, back pain, and leg pain following an education and exercise program for people with NS-LBP with or without LSS symptoms. They hypothesized that people with LSS symptoms would experience less improvement in all the outcomes measured.

From Dr. Thistle:

The results of this study show us that an exercise and education program for low back pain (in this case, the GLA:D Back program) has similar results for patients with and without symptoms of lumbar spinal stenosis. This is helpful for those in clinical practice and suggests that a standardized approach (at least to begin with) is a reasonable approach for back pain, even in those with symptoms suggestive of lumbar spinal stenosis. Of course, individualized care still reigns and each individual should received tailored attention depending on their goals and outcomes over time.

RESEARCH REVIEW: Patient-Reported Outcomes for Low Back Pain Patients After Structured Education & Exercise Program

This paper was published in BMC Musculoskeletal Disorders (2023)

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