Comparative effectiveness of supervised individual, group-based, and mixed physiotherapy approaches on pain and function in patients with chronic pain in primary care: a retrospective observational study

Background It remains unclear whether clinical outcomes from group-based physiotherapy are comparable to individual sessions, or if a mixed approach yields superior results in primary care. This study aimed to compare the effectiveness of supervised individual, group-based, and mixed physiotherapy approaches on pain and function in patients with chronic pain in primary care setting.Methods In this retrospective observational study, clinical records were analyzed for 124 patients (mean age 58.6 ± 12.4 years) with chronic pain (duration > 6 months). Patients received supervised individual (n = 55), group-based (n = 38), or mixed (n = 31) physiotherapy. The outcome measures assessed pre- and post-intervention were physical function, pain intensity, and perception of change.Results No significant between-group differences were observed in any outcome measure at post-intervention (p > .05). Conversely, a significant main effect of time was observed across all outcome measures in the three intervention groups (p < .001). Statistically significant improvements were observed in all three groups for physical function (individual: ∆ = 3.1 points, p < .001, d = 1.31; group-based: ∆ = 2.7 points, p < .001, d = 1.16; mixed: ∆ = 2.7 points, p < .001, d = 1.24). Similarly, a statistically significant decrease in pain intensity was observed in all groups, with a medium to large effect sizes and changes that exceeded the Minimally Clinically Important Difference (MCID) (individual: ∆ = -3.6 points, p < .001, d = -1.14; group-based: ∆ = -3.6 points, p < .001, d = -1.44; mixed: ∆ = -2.3 points, p < .001, d = -0.70). The perception of change also exceeded the MCID in all groups (individual: ∆ = 4.0 points; group-based: ∆ = 4.1 points; mixed: ∆ = 4.1 points).Conclusions In a primary care setting, supervised individual, group-based, and mixed physiotherapy interventions demonstrated comparable clinical effectiveness in reducing pain and improving physical function in patients with chronic musculoskeletal pain. Future randomized controlled trials with adequate follow-up periods are needed to validate these results.