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Graded exercise for recurrent low-back pain: a randomized, controlled trial with 6-, 12-, and 36-month follow-ups.
Spine (Phila Pa 1976). 2009 Feb 01; 34(3):221-8.S

Abstract

STUDY DESIGN

The study was a randomized controlled trial. Treatment was for 8 weeks, with follow-up posttreatment and at 6-, 12-, and 36- months.

OBJECTIVE

The purpose was to evaluate the effect of a graded exercise intervention emphasizing stabilizing exercises in patients with nonspecific, recurrent low back pain (LBP).

SUMMARY OF BACKGROUND DATA

Exercise therapy is recommended and widely used as treatment for LBP. Although stabilizing exercises are reportedly effective in the management of certain subgroups of LBP, such intervention protocols have not yet been evaluated in relation to a more general exercise regimen in patients with recurrent LBP, all at work.

METHODS

Seventy-one patients recruited consecutively (36 men, 35 women) with recurrent nonspecific LBP seeking care at an outpatient physiotherapy clinic were randomized into 2 treatment groups; graded exercise intervention or daily walks. The primary outcome was perceived disability and pain at 12-month follow-up. Secondary outcomes included physical health, fear-avoidance, and self-efficacy beliefs.

RESULTS

Of the participants, 83% provided data at the 12-month follow-up and 79% at 36 months. At 12 months, between-group comparison showed a reduction in perceived disability in favor of the exercise group, whereas such an effect for pain emerged only immediately postintervention. Ratings of physical health and self-efficacy beliefs also improved in the exercise group over the long term, though no changes were observed for fear-avoidance beliefs.

CONCLUSION

A graded exercise intervention, emphasizing stabilizing exercises, for patients with recurrent LBP still at work seems more effective in improving disability and health parameters than daily walks do. However, no such positive results emerged for improvement regarding pain over a longer term, or for fear-avoidance beliefs.

Authors+Show Affiliations

Department of Neurobiology, Care Sciences, and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden. eva.rasmussen.barr@ki.seNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

19179916

Citation

Rasmussen-Barr, Eva, et al. "Graded Exercise for Recurrent Low-back Pain: a Randomized, Controlled Trial With 6-, 12-, and 36-month Follow-ups." Spine, vol. 34, no. 3, 2009, pp. 221-8.
Rasmussen-Barr E, Ang B, Arvidsson I, et al. Graded exercise for recurrent low-back pain: a randomized, controlled trial with 6-, 12-, and 36-month follow-ups. Spine (Phila Pa 1976). 2009;34(3):221-8.
Rasmussen-Barr, E., Ang, B., Arvidsson, I., & Nilsson-Wikmar, L. (2009). Graded exercise for recurrent low-back pain: a randomized, controlled trial with 6-, 12-, and 36-month follow-ups. Spine, 34(3), 221-8. https://doi.org/10.1097/BRS.0b013e318191e7cb
Rasmussen-Barr E, et al. Graded Exercise for Recurrent Low-back Pain: a Randomized, Controlled Trial With 6-, 12-, and 36-month Follow-ups. Spine (Phila Pa 1976). 2009 Feb 1;34(3):221-8. PubMed PMID: 19179916.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Graded exercise for recurrent low-back pain: a randomized, controlled trial with 6-, 12-, and 36-month follow-ups. AU - Rasmussen-Barr,Eva, AU - Ang,Bjorn, AU - Arvidsson,Inga, AU - Nilsson-Wikmar,Lena, PY - 2009/1/31/entrez PY - 2009/1/31/pubmed PY - 2009/4/22/medline SP - 221 EP - 8 JF - Spine JO - Spine (Phila Pa 1976) VL - 34 IS - 3 N2 - STUDY DESIGN: The study was a randomized controlled trial. Treatment was for 8 weeks, with follow-up posttreatment and at 6-, 12-, and 36- months. OBJECTIVE: The purpose was to evaluate the effect of a graded exercise intervention emphasizing stabilizing exercises in patients with nonspecific, recurrent low back pain (LBP). SUMMARY OF BACKGROUND DATA: Exercise therapy is recommended and widely used as treatment for LBP. Although stabilizing exercises are reportedly effective in the management of certain subgroups of LBP, such intervention protocols have not yet been evaluated in relation to a more general exercise regimen in patients with recurrent LBP, all at work. METHODS: Seventy-one patients recruited consecutively (36 men, 35 women) with recurrent nonspecific LBP seeking care at an outpatient physiotherapy clinic were randomized into 2 treatment groups; graded exercise intervention or daily walks. The primary outcome was perceived disability and pain at 12-month follow-up. Secondary outcomes included physical health, fear-avoidance, and self-efficacy beliefs. RESULTS: Of the participants, 83% provided data at the 12-month follow-up and 79% at 36 months. At 12 months, between-group comparison showed a reduction in perceived disability in favor of the exercise group, whereas such an effect for pain emerged only immediately postintervention. Ratings of physical health and self-efficacy beliefs also improved in the exercise group over the long term, though no changes were observed for fear-avoidance beliefs. CONCLUSION: A graded exercise intervention, emphasizing stabilizing exercises, for patients with recurrent LBP still at work seems more effective in improving disability and health parameters than daily walks do. However, no such positive results emerged for improvement regarding pain over a longer term, or for fear-avoidance beliefs. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/19179916/Graded_exercise_for_recurrent_low_back_pain:_a_randomized_controlled_trial_with_6__12__and_36_month_follow_ups_ L2 - https://doi.org/10.1097/BRS.0b013e318191e7cb DB - PRIME DP - Unbound Medicine ER -