SAFE – Effectiveness of Mckenzie based self-management for the secondary prevention of a recurrence of low back pain.

Participants allocated to the McKenzie based self-management approach group will attend 2 x 30 minute individual sessions with a trained physiotherapist. These sessions will be approximately 2 weeks apart. The participant will be trained in an individualised simple specific exercise program focusing on movements that balance/counteract the postures or positions used throughout the day. Since the intervention is individualised for each participant, the exercises to be completed at home will vary in frequency and duration based on the judgement of the assessing physiotherapist to suit each individual's case. The intended exercises are aimed at changing habits, therefore therapists will emphasise the importance of continuing these exercises indefinitely as a prevention strategy for back pain recurrence. For most people the exercise program will involve lumbar extension to counteract the large amount of flexion activity typical of most people’s lives either in sitting or manual tasks, following a McKenzie approach. Adherence will be monitored by 1) recording attendance to physiotherapy visits, 2) asking physiotherapists to rate their perception of participant compliance to the home exercise program between the participants initial and final visit (2 weeks period) and 3) asking participants to rate compliance with home program using the Brief Adherence Rating Scale at 3, 6, 9 and 12 month follow-ups.