Comparison of three active therapies for chronic low back pain: results of a randomized clinical trial with one-year follow-up.
OBJECTIVE
To examine the relative efficacy of three active therapies for patients with chronic low back pain.


METHODS
One hundred and forty-eight subjects with chronic low back pain were randomized to receive, twice weekly for 3 months, (i) active physiotherapy, (ii) muscle reconditioning on training devices, or (ii) low-impact aerobics. Questionnaires were administered to assess pain intensity, pain frequency and disability before and after therapy and at 6 and 12 months of follow-up.


RESULTS
One hundred and thirty-two of the 148 patients (89%) completed the therapy programmes and 127 of the 148 (86%) returned a questionnaire at all four time-points. The three treatments were equally efficacious in significantly reducing pain intensity and frequency for up to 1 yr after therapy. However, the groups differed with respect to the temporal changes in self-rated disability over the study period (P=0.03): all groups showed a similar reduction after therapy, but for the physiotherapy group disability increased again during the first 6 months of follow-up whilst the other two groups showed a further decline. In all groups the values then remained stable up to the 12-month follow-up. The larger group size and minimal infrastructure required for low-impact aerobics rendered it considerably less expensive to administer than the other two programmes.


CONCLUSIONS
The introduction of low-impact aerobic exercise programmes for patients with chronic low back pain may reduce the enormous costs associated with its treatment.
Mannion
A F
AF
Department of Neurology, Schulthess Clinic, Zürich, Switzerland.
Müntener
M
M
Taimela
S
S
Dvorak
J
J
D000328:Adult; D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000191:economics / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010809:Physical Fitness; D026741:Physical Therapy Modalities; D011795:Surveys and Questionnaires; D016896:Treatment Outcome