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Physiotherapist-directed exercise, advice, or both for subacute low back pain: a randomized trial
Liset H M Pengel1, Kathryn M Refshauge, Christopher G Maher
1Royal College of Surgeons of England, London, United Kingdom.
Annals of Internal Medicine
|June 6, 2007
Summary
Physiotherapist-guided exercise and advice showed short-term benefits for subacute low back pain, with combined interventions yielding the greatest initial improvements. Long-term effects were minimal, with only participant-reported function showing sustained benefits at 12 months.
Area of Science:
- Physiotherapy
- Musculoskeletal Health
- Evidence-Based Practice
Background:
- Subacute low back pain is common, with exercise and advice frequently recommended.
- The comparative effectiveness of these interventions remains unclear.
Purpose of the Study:
- To evaluate the efficacy of physiotherapist-prescribed exercise, advice, or both for subacute low back pain.
Main Methods:
- A factorial randomized, placebo-controlled trial involving 259 participants.
- Interventions included 12 exercise or sham exercise sessions and 3 advice or sham advice sessions over 6 weeks.
- Primary outcomes assessed pain, function, and global perceived effect at 6 weeks and 12 months.
Main Results:
- Both exercise and advice individually showed slight superiority over placebo at 6 weeks for pain and function.
- Combined exercise and advice demonstrated the largest effects at 6 weeks.
- At 12 months, only participant-reported function showed a statistically significant improvement with combined interventions.
Conclusions:
- Physiotherapist-directed exercise and advice offer short-term benefits for subacute low back pain.
- Combined interventions provide the most significant short-term relief.
- Long-term benefits are limited, with sustained improvements primarily observed in participant-reported function.