[Cesar therapy is temporarily more effective in patients with chronic low back pain than the standard treatment by family practitioner: randomized, controlled and blinded clinical trial with 1 year follow-up].
OBJECTIVE
To determine the effectiveness of a special form of exercise therapy ('Cesar therapy') on self reported recovery and improvement of posture amongst patients with chronic aspecific lower back pain.


METHODS
Prospective randomized controlled and blinded investigation.


METHODS
After informed consent had been obtained, patients with chronic aspecific lower back pain were given, on a randomized basis, either an exercise therapy (experimental group, n = 112) or a standard treatment by their general practitioner (control group, n = 110). Outcome measures were self reported recovery of back pain and improvement of posture (thoracic and lumbar spine, pelvis). Self reported recovery was determined by means of a dichotomized 7-point scale (questionnaire). Posture was measured qualitatively by a panel of 11 Cesar therapists (blinded) and quantitatively by an optical-electronic posture recording system (Vicon). Measurements were taken at baseline (pre-randomization) and at 3, 6 and 12 months after randomization.


RESULTS
Three months after randomization, patients who were treated according to Cesar therapy, reported an improvement in their back symptoms (80%) significantly more often than the control group (47%). In both groups, however, only small improvements in posture were found. The judgement of the Cesar panel exhibited a significant difference between the two groups, with respect to the spine, in favour of Cesar therapy. Differences between the groups were still present 6 months after randomization, but could no longer be detected at 12 months after randomization.


CONCLUSIONS
Cesar therapy was significantly more effective than standard treatment among patients with chronic lower back pain for a period of 6 months after randomization.
Hildebrandt
V H
VH
Afd. Beleidsonderzoek Arbeid en Gezondheid, TNO Arbeid, Hoofddorp. v.hildebrandt@arbeid.tno.nl
Proper
K I
KI
van den Berg
R
R
Douwes
M
M
van den Heuvel
S G
SG
van Buuren
S
S
D000328:Adult; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005194:Family Practice / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D009426:Netherlands; D010147:Pain Measurement; D011187:Posture; D017410:Practice Guidelines as Topic; D020127:Recovery of Function; D016037:Single-Blind Method; D013131:Spine / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome