Journal Article

Effects of an additional multimodal intervention (MultiMove) during inpatient rehabilitation on clinical and functional outcomes in patients with chronic low back pain– a pilot trial

Rohkohl, Kerstin, Nguyen, Toan, Bielitzki, Robert, Meiler, Katharina, Behrens, Martin, Rudolph, Ivonne, Schega, Lutz, Broscheid, Kim-Charline, Franke, Jörg

2025

Overview

Background As a leading cause of disability, chronic low back pain (CLBP) is a musculoskeletal condition often associated with impaired physical and cognitive functions. Due to its multi-factorial facets, the application of multimodal interventions is recommended. MultiMove is a multimodal intervention designed for CLBP patients, which combines motor-cognitive and dancing exercises. This study aimed to assess the effects of an additional MultiMove intervention to a standard inpatient rehabilitation on clinical and functional outcomes in CLBP patients. Methods For this prospective, two-arm, controlled pilot trial, 27 CLBP patients (17 females, 10 males) undergoing a 3-week inpatient rehabilitation, in a rehabilitation clinic in Germany, were recruited. The intervention group (IG, n  = 15, 61.6 ± 1.8 years) received a daily MultiMove session in addition to the standard rehabilitation, while the control group (CG, n  = 12, 63.8 ± 2.2 years) followed the standard rehabilitation. Physical (Timed Up and Go (TUG) [primary outcome], Five-Repetition Sit-to-Stand (FRSTS), and Six-Minute Walk Test (6MWT), trunk range of motion, single and dual task walking)), clinical (acute/chronic pain intensity, Oswestry Disability Index, EQ-5D-5 L), cognitive (Stroop Color Word Test, Trail Making Test), and psychosocial outcomes (Tampa Scale of Kinesiophobia, Beck Depression Inventory-II, Coping Strategies Questionnaire) were assessed during the first (pre-test) and last day (post-test) of the inpatient rehabilitation. Results The statistical analyses revealed improvements in trunk range of motion (sagittal plane: p  = 0.018, d  = 1.00; transversal plane: p  = 0.006, d  = 1.18) and 6MWT performance ( p  = 0.003, d  = 1.30) in the IG compared to the CG. Moreover, lower dual task costs for a gait variability measure ( p  = 0.034, d  = 0.97) as well as reduced chronic pain intensity ( p  = 0.004, d  = 1.33), kinesiophobia ( p  = 0.035, d  = 1.15), and depression ( p  = 0.034, d  = 1.08) were found in favour of the IG. Conclusion Data indicate that the multimodal intervention MultiMove improved clinical and functional outcomes in CLBP patients during inpatient rehabilitation. Therefore, conducting a randomized controlled trial with a large sample size is recommended to verify and extent these results. Trial registration MultiMove project (German Clinical Trial Register, ID: DRKS00021696 / 10.07.2020, https://drks.de/drks_web/navigate.do?navigationId=trial.HTML26TRIAL_ID=DRKS00021696 ) and was carried out in the rehabilitation clinic Bad Salzelmen (Schönebeck, Germany).

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aged / Back pain / Care and treatment / Chronic pain / Chronic Pain - diagnosis / Chronic Pain - physiopathology / Chronic Pain - psychology / Chronic Pain - rehabilitation / Cognitive ability / Cognitive functions / Cognitive therapy / Combined Modality Therapy - methods / Coping / Dance therapy / Dancing / Epidemiology / Executive function / Exercise therapy / Exercise Therapy - methods / Female / Functional mobility / Gait / Germany / Group therapy / Hospital patients / Humans / Immunoglobulins / Inpatients / Internal Medicine / Intervention / Low back pain / Low Back Pain - diagnosis / Low Back Pain - physiopathology / Low Back Pain - psychology / Low Back Pain - rehabilitation / Male / Medicine / Medicine & Public Health / Middle Aged / Mobility / Orthopedics / Pain Measurement / Physical functions / Pilot Projects / Prospective Studies / Quality of life / Questionnaires / Recovery of Function / Rehabilitation / Rheumatology / Sports Medicine / Statistical analysis / Testing / Treatment Outcome / Walking