Outcomes with Individual versus Group Physical Therapy for Treating Urinary Incontinence and Low Back Pain

The objective of this study was to evaluate the existing evidence comparing the outcomes of rehabilitation conducted in a group setting to individual therapy for patients receiving rehabilitation. Electronic databases MEDLINE, CINAHL, EMBASE, PEDro and OT Seeker were searched from the earliest date possible to July 2013. Additional references were identified by manual scanning of reference lists. Randomized controlled trials examining the effect of group therapy compared to individual therapy for patients receiving rehabilitation were included for review. Two reviewers independently applied the inclusion and exclusion criteria to identify included articles. Initial search identified 1,527 potential articles, of which 16 trials with 2,337 participants were included in the final review. Data extraction was completed for all included trials by one reviewer, using a customised data extraction form. Data was checked for accuracy by a second reviewer. Trials were independently assessed by two reviewers for methodological quality employing the PEDro scale. Trials that met inclusion criteria were conducted in back pain (n=6 studies), urinary incontinence (n=5), learning disability (n=2), hearing loss (n=1), joint replacement (n=1) and aphasia (n=1). Meta-analysis of physical therapy trials in back pain and urinary incontinence reporting sufficient homogenous data exhibited no significant difference in outcomes for group compared to individual therapy. These results were also supported by qualitative analysis of the remaining studies in these populations, but there is insufficient evidence to draw conclusions regarding other clinical areas.

Evidence demonstrates that providing rehabilitation in a group format results in equivalent clinical outcomes to provision of similar therapy in an individual format in the treatment of back pain and urinary incontinence. At this time there is not sufficient evidence to draw similar conclusions in other populations or fields of rehabilitation.