Strength, mobility, their changes, and pain reduction in active functional restoration for chronic low back disorders

Area of Science:

• Rehabilitation Medicine
• Clinical Biomechanics
• Pain Management

Background:

• Chronic low back pain (CLBP) affects a significant portion of the population, leading to disability and reduced quality of life.
• Multidimensional back treatment programs aim to restore function and alleviate pain in CLBP patients.
• Understanding the relationship between subjective pain relief and objective functional gains is crucial for optimizing rehabilitation strategies.

Purpose of the Study:

• To investigate the association between subjective pain reduction and objective improvements in physical functioning in CLBP patients undergoing active functional restoration.
• To determine if the magnitude of functional improvement correlates with the degree of pain reduction.

Main Methods:

• A cohort of 143 CLBP patients participated in a 12-week multidimensional back treatment program.
• Objective measurements included low back range of motion (flexion-extension, lateral flexion, rotation), isometric strength, and mobility.
• Subjective pain levels and changes in physical functioning were assessed throughout the program.

Main Results:

• Approximately 79% of patients reported a subjective decrease in low back pain.
• Simultaneously, about 80% of patients showed objective increases in isometric strength and mobility.
• While pain reduction and functional improvement occurred in the same individuals, the correlation between specific physical functioning parameters and pain reduction was low (rs < 0.22).
• Baseline strength and mobility, as well as the magnitude of changes, were not significantly associated with pain reduction.

Conclusions:

• Subjective pain reduction in CLBP patients undergoing active functional restoration is associated with the presence of improved trunk muscle function and spinal mobility, rather than the magnitude of these improvements.
• These findings suggest that rehabilitation programs and outcome criteria should consider the per se improvement in function, not solely the degree of change, when evaluating treatment success for CLBP.