Mobility, Strength, and Fitness After a Graded Activity... : Spine (original) (raw)
Original Article: PDF Only
Mobility, Strength, and Fitness After a Graded Activity Program for Patients with Subacute Low Back Pain
A Randomized Prospective Clinical Study with a Behavioral Therapy Approach
Lindström, Ingalill RPT*; Öhlund, Carl MD*; Eek, Claes BSc†; Wallin, Leif MD PhD†; Peterson, Lars-Erik BSc‡; Nachemson, Alf MD, PhD*
*Department of Orthopaedics, University of Göteborg, Sahlgren Hospital, Göteborg, Sweden
†Volvo Company, University of Göteborg, Sahlgren Hospital, Göteborg, Sweden
‡Department of Statistics, University of Göteborg, Göteborg, Sweden
Abstract
Patients with nonspecific mechanical low back pain (n = 103), examined by an orthopaedic surgeon and a social worker, were randomized to an activity group (n = 51) and a control group (n = 52). Patients with defined orthopaedic, medical, or psychiatirc diagnoses were excluded before randomization. No patients were excluded due to place of birth or difficulties in speaking or understanding the Swedish language. The purpose of the study was to compare mobility, strength and fitness after traditional care and after traditional care plus a graded activity program with a behavioral therapy approach. A graded activity program, with a behavioral therapy approach was given under the guidance of a physical therapist. The endpoint of the graded activity program was return to work. This program significantly increased mobility, strength, and fitness more than could be explained by only a time recovery effect, especially in males. The patients in the activity group returned to work earlier than did the patients in the control group. Spinal rotation, abdominal muscle endurance time and lifting capacity were significantly correlated to rate of return to work. Traditional care plus a graded activity program were superior to only traditional care, evaluated in terms of mobility, strength and fitness. The graded activity program proved to be a successful method of restoring occupational function and facilitating return to work in subacute low back pain patients. The patients in the graded activity program learned that it is safe to move, while regaining function.
© Lippincott-Raven Publishers.