Changes in disability following physical therapy intervention for patients with low back pain: dependence on symptom duration.
OBJECTIVE
To assess the impact of symptom duration on functional outcome, functional improvement, pain, and patient perception of recovery after a physical therapy (PT) program for low back pain (LBP) and to determine what variables are significantly associated with improved function.


METHODS
Retrospective case series.


METHODS
Outpatient setting at a tertiary care facility.


METHODS
Patients (N=130) who were seen for PT between June 2003 and November 2004.


METHODS
A customized rehabilitation program was developed for each patient based on examination findings and included a combination of the following interventions: mobilization/manipulation, flexibility exercises, strengthening exercises, endurance exercises, massage techniques, and heat and cold modalities.


METHODS
Functional outcome, functional improvement, perceived pain, and perceived improvement scores in the CareConnections Outcomes System (formerly TAOS) database.


RESULTS
Persons whose symptom duration was greater than 6 months had significantly less functional improvement than persons whose symptom duration was less than 1 month. The median percentage improvement score for perceived recovery was also significantly lower for the chronic group than for the acute group. There was no significant difference in the percentage decrease in pain among the acute, subacute, and chronic groups. In regression analyses, a model with age (P=.001), symptom duration (P=.002), and inclusion of strengthening, flexibility, and mobilization and manipulation exercises (P=.001) fit the data well and explained 55.5% of the variance in functional improvement score for all 3 groups combined.


CONCLUSIONS
Patients showed improvements in function following a rehabilitation program for LBP. The functional improvement score is influenced by age, symptom duration, and inclusion of mobilization/manipulation and strengthening and flexibility exercises.
Badke
Mary Beth
MB
Department of Orthopedics and Rehabilitation, University of Wisconsin Hospital and Clinics, Madison, WI, USA. mb.badke@hosp.wisc.edu
Boissonnault
William G
WG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002648:Child; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D020127:Recovery of Function / Q000502:physiology*; D012044:Regression Analysis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome