The short-term effects of graded activity versus physiotherapy in patients with chronic low back pain: A randomized controlled trial

Author(s)

Magalhaes, Mauricio Oliveira ^[1] ; Muzi, Luzilauri Harumi ^[1] ; Comachio, Josielli ^[1] ; Burke, Thomaz Nogueira ^{[1, 2]} ; Renovato Franca, Fabio Jorge ^[1] ; Vidal Ramos, Luiz Armando ^{[1, 3]} ; Leao Almeida, Gabriel Peixoto ^{[1, 4]} ; de Moura Campos Carvalho-e-Silva, Ana Paula ^[1] ; Marques, Amelia Pasqual ^[1]

Affiliation

^[1] Univ Sao Paulo, Sch Med, Phys Therapy Speech & Occupat Therapy Dept, Sao Paulo - Brazil

^[2] Univ Fed Sao Paulo, Biosci Div, Sao Paulo - Brazil

^[3] Univ Fed Amapa, Amapa - Brazil

^[4] Univ Fed Ceara, Sch Med, Div Phys Therapy, Fortaleza, Ceara - Brazil

• Document type: Journal article
• Source: MANUAL THERAPY; v. 20, n. 4, p. 603-609, AUG 2015.
• Web of Science Citations: 8

Abstract

Background: Chronic low back pain is one of the most common problematic health conditions worldwide and is highly associated with disability, quality of life, emotional changes, and work absenteeism. Graded activity programs, based on cognitive behavioral therapy, and exercises are common treatments for patients with low back pain. However, recent evidence has shown that there is no evidence to support graded activity for patients with chronic nonspecific low back pain. Aim: to compare the effectiveness of graded activity and physiotherapy in patients with chronic nonspecific low back pain. Methods: A total of 66 patients with chronic nonspecific low back pain were randomized to perform either graded activity (moderate intensity treadmill walking, brief education and strength exercises) or physiotherapy (strengthening, stretching and motor control). These patients received individual sessions twice a week for six weeks. The primary measures were intensity of pain (Pain Numerical Rating Scale) and disability (Rolland Morris Disability Questionnaire). Results: After six weeks, significant improvements have been observed in all outcome measures of both groups, with `a non-significant difference between the groups. For intensity of pain (mean difference = 0.1 points, 95% confidence interval {[}CI] = 1.1-1.3) and disability (mean difference = 0.8 points, 95% confidence interval {[}CI] = 2.6-4.2). No differences were found in the remaining outcomes. Conclusion: The results of this study suggest that graded activity and physiotherapy showed to be effective and have similar effects for patients with chronic nonspecific low back pain. (C) 2015 Elsevier Ltd. All rights reserved. (AU)

• FAPESP's process: 12/18182-5 - Effect of Cognitive behavioural therapy and exercise versus supervised exercise in patients with chronic non specific low back pain: A randomized controlled trial
• Grantee: Maurício Oliveira Magalhães
• Support Opportunities: Scholarships in Brazil - Doctorate