הטיפול בכאבי גב תחתון לפי הקווים המנחים העולמיים באמצעות גישת Enhanced Transtheoretical Model Intervention (ETMI): [סקירת ספרות]

Background and Objectives: Low back pain is the world’s leading cause of impaired quality of life and disability. According to global guidelines, the treatment for low back pain is self-management of symptoms,normal life routine, and adherence to physical activity.Enhanced Transtheoretical Model Intervention (ETMI) is a treatment approach based on behavioral models that can guide patients to be physically active and manage their back pain by themselves. The purpose of this review is to provide background and information on the ETMI approach and present its clinical and economic efficacy as shown in research.Methods: The ETMI approach will be described in the article as follows: 1. a general description of the ETMI approach and the controlled clinical study that examined clinical and economic efficacy; 2. a qualitative study that examined the prior expectations and perceptions of 30 patients with chronic low back pain towards physiotherapy treatment in general, and ETMI approach in particular; 3. a qualitative study examining the perceptions of 26 physiotherapists about the implementation of ETMI in their clinical field;4. a mixed methods study that examined the out come measures as well as the perceptions of 30 chronic patients with low back pain after being treated according to the ETMI approach; and 5. finally, the study of the implementation of the ETMI approach in the public health system is described.Results: The controlled clinical trial found a significant improvement in function, pain, and quality of life. In addition, a significant reduction in treatment costs resulted in overall financial efficiency. The qualitative studies identified the barriers to adopting the ETMI approach and its implementation in a public health system.Conclusions: Implementing the ETMI approach in a public health system as primary care for patients with low back pain is not a simple task. The barriers of patients and practitioners, as well as the health system’s requirements must be taken into account. It seems that the use of ETMI within the health system can lead to an improvement in patients’ functioning and a reduction in the costs of treating low back pain.