Gerhard Müller, Manuela Pfinder, Michael Clement, Andreas Kaiserauer, Guido Deis, Timm Waber, Stefanie Rieger, Dana Schwarz, Monika Heinzel-Gutenbrunner, Michael Straif, Klaus Bös, Thomas Kohlmann
Department of Product Management, AOK Baden-Wuerttemberg, DE-76646 Bruchsal, Germany. E-mail: gerhard.mueller@bw.aok.de
DOI: 10.2340/16501977-2497

To compare the cost-effectiveness of a multimodal back exercise programme for non-specific back pain with that of standard treatment. Medical costs were measured in euros (EUR) and effectiveness was measured using Graded Chronic Pain Status (GCPS).
A controlled multicentre study (39 sites) with a 6-month intervention phase and follow-up at 6, 12 and 18 months.
The study included 1,829 participants in an intervention group and 495 individuals in a control group.
The multimodal back exercise programme comprises 36 exercise sessions for optimizing the spine stabilizing muscles and everyday motor func-tions. The patients were given a home training programme at the end of the intervention programme.
The back exercise programme resulted in a significant reduction, of 0. 4, in back pain grade on the GCPS after 2 years, compared with standard treat-ment, and reduced medical costs by 763 EUR. The exercise programme was therapeutically effective for GCPS back pain grades 1–4 and produced cost savings in the case of grade 4 GCPS.
The multimodal back exercise programme was therapeutically effective for back pain (grades 1–2) and pain-related functional impairment (grades 3–4). It resulted in reduced costs for chronic back pain causing high pain-induced functional impairment (grade 4). The therapeutic and economic effects of the programme increase with the grade of back pain.

This study compared the cost-effectiveness of a back exercise programme for different levels of back pain with standard treatment. The back exercise programme resulted in a reduction in back pain after 2 years compared with standard treatment. Moreover, the exercise programme resulted in reduced medical costs. The back exercise programme was found to be therapeutically effective and cost-efficient. The therapeutic and economic effects of the programme increased with severity of back pain.