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Effectiveness of an extension-oriented treatment approach in a subgroup of subjects with low back pain: a randomized clinical trial.
Phys Ther. 2007 Dec; 87(12):1608-18; discussion 1577-9.PT

Abstract

BACKGROUND AND PURPOSE

The purpose of this multicenter randomized clinical trial was to examine the effectiveness of an extension-oriented treatment approach (EOTA) in a subgroup of subjects with low back pain (LBP) who were hypothesized to benefit from the treatment compared with similar subjects who received a lumbar spine strengthening exercise program.

METHODS

Subjects with LBP and symptoms distal to the buttocks that centralized with extension movements were included. Forty-eight subjects were randomly assigned to groups that received an EOTA (n=26) or a strengthening exercise program (n=22). Subjects attended 8 physical therapy sessions and completed a home exercise program. Follow-up data were obtained at 1 week, 4 weeks, and 6 months after randomization. Primary outcome measures were disability (modified Oswestry Low Back Pain Disability Questionnaire) and pain (Numeric Pain Rating Scale).

RESULTS

Subjects in the EOTA group experienced greater improvements in disability compared with subjects who received trunk strengthening exercises at 1 week (mean difference between groups from baseline=8.9, 95% confidence interval [CI]=2.0, 15.9), 4 weeks, (mean difference=14.4, 95% CI=4.8, 23.9), and 6 months (mean difference=14.6, 95% CI=4.6, 24.6). The EOTA group demonstrated greater change in pain at the 1-week follow-up only.

DISCUSSION AND CONCLUSION

An EOTA was more effective than trunk strengthening exercise in a subgroup of subjects hypothesized to benefit from this treatment approach. Additional research is needed to explore whether an EOTA may benefit other subgroups of patients.

Authors+Show Affiliations

Outpatient Physical Therapy, Physical Therapy Department, Wilford Hall Medical Center, San Antonio, TX, USA. david.browder@lackland.af.milNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17895350

Citation

Browder, David A., et al. "Effectiveness of an Extension-oriented Treatment Approach in a Subgroup of Subjects With Low Back Pain: a Randomized Clinical Trial." Physical Therapy, vol. 87, no. 12, 2007, pp. 1608-18; discussion 1577-9.
Browder DA, Childs JD, Cleland JA, et al. Effectiveness of an extension-oriented treatment approach in a subgroup of subjects with low back pain: a randomized clinical trial. Phys Ther. 2007;87(12):1608-18; discussion 1577-9.
Browder, D. A., Childs, J. D., Cleland, J. A., & Fritz, J. M. (2007). Effectiveness of an extension-oriented treatment approach in a subgroup of subjects with low back pain: a randomized clinical trial. Physical Therapy, 87(12), 1608-18; discussion 1577-9.
Browder DA, et al. Effectiveness of an Extension-oriented Treatment Approach in a Subgroup of Subjects With Low Back Pain: a Randomized Clinical Trial. Phys Ther. 2007;87(12):1608-18; discussion 1577-9. PubMed PMID: 17895350.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of an extension-oriented treatment approach in a subgroup of subjects with low back pain: a randomized clinical trial. AU - Browder,David A, AU - Childs,John D, AU - Cleland,Joshua A, AU - Fritz,Julie M, Y1 - 2007/09/25/ PY - 2007/9/27/pubmed PY - 2008/1/25/medline PY - 2007/9/27/entrez SP - 1608-18; discussion 1577-9 JF - Physical therapy JO - Phys Ther VL - 87 IS - 12 N2 - BACKGROUND AND PURPOSE: The purpose of this multicenter randomized clinical trial was to examine the effectiveness of an extension-oriented treatment approach (EOTA) in a subgroup of subjects with low back pain (LBP) who were hypothesized to benefit from the treatment compared with similar subjects who received a lumbar spine strengthening exercise program. METHODS: Subjects with LBP and symptoms distal to the buttocks that centralized with extension movements were included. Forty-eight subjects were randomly assigned to groups that received an EOTA (n=26) or a strengthening exercise program (n=22). Subjects attended 8 physical therapy sessions and completed a home exercise program. Follow-up data were obtained at 1 week, 4 weeks, and 6 months after randomization. Primary outcome measures were disability (modified Oswestry Low Back Pain Disability Questionnaire) and pain (Numeric Pain Rating Scale). RESULTS: Subjects in the EOTA group experienced greater improvements in disability compared with subjects who received trunk strengthening exercises at 1 week (mean difference between groups from baseline=8.9, 95% confidence interval [CI]=2.0, 15.9), 4 weeks, (mean difference=14.4, 95% CI=4.8, 23.9), and 6 months (mean difference=14.6, 95% CI=4.6, 24.6). The EOTA group demonstrated greater change in pain at the 1-week follow-up only. DISCUSSION AND CONCLUSION: An EOTA was more effective than trunk strengthening exercise in a subgroup of subjects hypothesized to benefit from this treatment approach. Additional research is needed to explore whether an EOTA may benefit other subgroups of patients. SN - 0031-9023 UR - https://www.unboundmedicine.com/medline/citation/17895350/Effectiveness_of_an_extension_oriented_treatment_approach_in_a_subgroup_of_subjects_with_low_back_pain:_a_randomized_clinical_trial_ L2 - https://academic.oup.com/ptj/article-lookup/doi/10.2522/ptj.20060297 DB - PRIME DP - Unbound Medicine ER -