None listed
Conditions
Brief summary
About 1 in 10 Australians have persisting or chronic low back pain. Most are managed in primary care and the most frequently prescribed treatment is exercise. Chronic low back pain remains a major health problem because not all patients respond to each treatment so on average treatment effects are small. At present there are no guidelines to help clinicians select the best treatment for a patient. As a result, time and money is wasted on treatments which ultimately fail to help the patient. Our proposed study is a direct comparison of the two most promising types of exercise approaches used in Australia: a graded activity program where patients perform an individualised, whole body exercise program, and a motor control program, where patients perform a series of specific spinal stabilisation exercises. This study will compare the effects of these two interventions. We will also identify patient features that may predict a patient's response to treatment. Prediction features used will be clinical/demographic data, measures of beliefs and attitudes about pain, measures of physical activity and fitness, measures of control and co-ordination of the lumbar spine and pelvis.
Interventions
Pragmatic randomised controlled trial with 172 subjects randomised to two treatment groups (i) motor control exercise (ii) graded activity. Both treatments will consist of 12 one hour treatments over an 8 week period, ie: 2 sessions/week in the first month and 1 session/week in the second month and 2 additional 1 hour follow-up sessions at 4 & 10 months. Patients will be advised to do home exercises, consistent with the exercise approach they are receiving. The total time for home exercises wi
Pragmatic randomised controlled trial with 172 subjects randomised to two treatment groups (i) motor control exercise (ii) graded activity. Both treatments will consist of 12 one hour treatments over an 8 week period, ie: 2 sessions/week in the first month and 1 session/week in the second month and 2 additional 1 hour follow-up sessions at 4 & 10 months. Patients will be advised to do home exercises, consistent with the exercise approach they are receiving. The total time for home exercises will sum to at least 1/2 hour/week in the first month and 1 hr/week in the second month. The treatment sessions and home exercises will add up to at least 20 hours of treatment.
Sponsors
The University of Sydney
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Non specific low back pain +/- leg pain persisting for at least 3 months. Currently seeking treatment for low back pain. Clinical assessment indicates that the subject is suitable for active exercises. At least "moderate" on item 7 or 8 of the SF 36.
Exclusion criteria
Known or suspected serious spinal pathology. Nerve root compromise. Previous spinal surgery or scheduled for major surgery during the treatment or follow-up period. Co-morbid health conditions that would prevent active participation in exercise programs.
Outcome results
None listed