[Non-operative treatment of chronic low back pain: specific back muscular strength training versus improvement of physical fitness].
OBJECTIVE
A systematic review was performed to evaluate the clinical effects of specific back muscle and non-specific physical fitness training in chronic low back pain.


METHODS
A computer-aided Medline research (19861999) of randomised clinical trials concerning both rehabilitation concepts was conducted. A rating system was used to assess the methodological score of each study. The results were analysed and a final statement for evidence according to three main parameters (back pain, physical capacity, and patients comfort) was postulated.


RESULTS
Twelve randomised clinical trials were identified. Nine studies were determined as high-quality trials. For chronic low back pain specific back muscle exercises as well as non-specific fitness training were able to improve the patients' conditions sufficiently. In comparison with passive treatment or no treatment there is strong evidence for pain and physical capacity in both groups, but only a positive influence for patient' comfort in fitness groups. Nevertheless, a confrontation of both concepts in two studies did not reveal any notable differences in all three parameters.


CONCLUSIONS
Principally, a specific strength training for back rnuscles as well as a non-specific fitness training are comparably effective to rehabilitate chronic low back pain.
Weinhardt
C
C
Orthopädische Klinik, Herzogin Elisabeth Heim, Braunschweig, Germany. chkawei@hotmail.com
Heller
K D
KD
Weh
L
L
D003131:Combined Modality Therapy; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D010809:Physical Fitness; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014891:Weight Lifting