Background: Chronic low back pain is a prevalent and disabling condition with significant physical, psychological, and socio-economic consequences. Effective management requires a multidimensional approach [1].

Objectives: This study aimed to compare the effectiveness of three distinct rehabilitation strategies: conventional rehabilitation alone, Global Postural Reeducation (GPR), and Pain Neuroscience Education (PNE), each combined with conventional rehabilitation in addressing pain, functional limitations, and psychological distress in patients with chronic low back pain.

Methods: A longitudinal comparative study was conducted from March to May 2024, involving patients with chronic low back pain randomized into three groups: a control group receiving conventional rehabilitation alone, a GPR group combining GPR to conventional rehabilitation, and a PNE group combining PNE to conventional rehabilitation. Each intervention lasted four weeks with three one-hour sessions per week. Assessments were conducted at baseline (T0) and after the intervention (T1) using the Visual Analog Scale (VAS) for pain intensity, the Oswestry Disability Index (ODI) for functional impairment, and the Hospital Anxiety and Depression Scale (HADS) for psychological status.

Results: A total of 48 patients were included in the study, divided into three groups: 24 in the control group, 13 in the GPR group, and 11 in the PNE group. The average age was 51 ± 11 years in the control group, 46 ± 5 years in the GPR group, and 53 ± 9 years in the PNE group. Regarding sex distribution, all participants in the control and GPR groups were female, while the PNE group included 4 males and 7 females. The average BMI was 26 ± 2 Kg/m ² in the control group, 25.9 ± 3 Kg/m ² in the GPR group, and 27 ± 4 25.9 ± 3 Kg/m ² in the PNE group. The average duration of chronic low back pain was 17 ± 2 months in the control group, 18 ± 6 months in the GPR group, and 17 ± 5 months in the PNE group. Following the rehabilitation protocols, pain intensity improved significantly in all groups: from 6.18 ± 1.1 to 3.13 ± 0.3 in the control group, from 5 ± 0.5 to 2 ± 0.1 in the GPR group, while the PNE group achieved the most substantial improvement, with a reduction from 7.18 ± 1.9 to 2.63 ± 0.1, which was statistically superior to the control group (p=0.04). Psychological status also improved across all groups: the control group showed a 7-point decrease from 11 ± 2.3 to 4 ± 0.9, and the GPR group demonstrated an improvement of 7.4 points from 11.07 ± 1.2 to 3.6 ± 0.4. However, the most significant improvement was observed in the PNE group, with HADS scores dropping by 7.9 points from 10.9 ± 2.5 to 3 ± 0.1, a statistically significant difference compared to both the control and GPR groups (p=0.02). Similarly, functional capacity, as measured by the ODI, improved across all groups, with the GPR group achieving the most significant reduction, decreasing from 21% to 8.5% (p=0.03 compared to the control group), while the PNE group showed a reduction of 10.8%, which was not statistically significant.

Conclusion: This study highlights the effectiveness of combining innovative rehabilitation techniques with conventional approaches in the management of chronic low back pain. PNE was most effective in reducing pain and improving psychological status, while GPR showed superior outcomes in functional capacity. These findings emphasize the value of a multidimensional approach to optimize patient outcomes and recommend the integration of these techniques into routine care.

REFERENCES: [1] Andronis L, Kinghorn P, Qiao S, Whitehurst DG, Durrell S, McLeod H. Cost-Effectiveness of Non-Invasive and Non-Pharmacological Interventions for Low Back Pain: a Systematic Literature Review. Appl Health Econ Health Policy. 2017;15(2):173-201.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.