Related Experiment Video
Updated: May 26, 2026
Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
The effectiveness of graded activity in patients with non-specific low-back pain: a systematic review
R N van der Giessen1, C M Speksnijder, P J M Helders
1Department of Physiotherapy Science, Clinical Health Sciences, Utrecht University, Utrecht, The Netherlands.
Background:
Non-specific low-back pain (LBP) is considered a major health and economic problem in Western society. Nowadays a common used intervention on non-specific LBP is graded activity (GA). Graded Activity developed by Lindström et al., consisted of four parts: (i) measurements of functional capacity; (ii) a work-place visit; (iii) back school education and (iv) an individual, sub-maximal, gradually increased exercise program with an operant-conditioning behavioural approach as described by Fordyce et al.
Objective:
To evaluate the effectiveness of GA in adults with non-specific LBP on pain, disabilities and return to work.
Data Sources:
An extensive literature search of PubMed, Embase, CINAHL and The Cochrane Library was conducted in July 2011.
Review Methods:
Randomized controlled trials (RCTs) evaluating the effect of GA in patients with non-specific LBP were eligible. Methodological quality of the studies was assessed according to the PEDro scale. A best-evidence synthesis was conducted according to van Peppen et al. to interpret the outcomes of the included studies.
Results:
Ten articles were included in this systematic review; these articles described five RCTs (680 patients). The best-evidence synthesis revealed that there was no or insufficient evidence for a positive effect of GA on pain, disabilities and return to work in patients with non-specific LBP.
Conclusion:
Currently there is no or insufficient evidence that GA results in better outcomes of patients with non-specific LBP.