Comparison of a functional restoration program with active individual physical therapy for patients with chronic low back pain: a randomized controlled trial.
OBJECTIVE
To compare the short-term outcomes of active individual therapy (AIT) with those of a functional restoration program (FRP).


METHODS
Prospective randomized controlled study.


METHODS
Two rehabilitation centers and private ambulatory physiotherapy facilities.


METHODS
One hundred thirty-two adults with chronic low back pain. Fifty-one percent of patients on sick leave or out of work (mean duration, 180d in the 2y before treatment).


METHODS
For 5 weeks, FRP (at 25h/wk) or AIT (at 3h/wk).


METHODS
Trunk flexibility, back flexor, and extensor endurance (Ito and Sorensen tests), general endurance, pain intensity, Dallas Pain Questionnaire (DPQ) scores, daily activities, anxiety depression, social interest, and work and leisure activities, and self-reported improvement (work ability, resumption of sport and leisure activities).


RESULTS
All outcome measures improved after treatment except endurance in AIT. There was no between-group difference for pain intensity or DPQ daily activities or work and leisure activities scores. Better results were observed in FRP for all other outcome measures. There was a significant effect of treatment and the initial value for the gain of the Sorensen score with a treatment or initial value interaction; a significant effect of treatment and initial value on the gains of Ito, endurance, and DPQ social interest and anxiety depression scores, with no treatment or initial value interaction; and a significant effect of initial value but not treatment for the gains of DPQ daily activities and work and leisure activities scores.


CONCLUSIONS
Low-cost ambulatory AIT is effective. The main advantage of FRP is improved endurance. We speculate that this may be linked to better self-reported work ability and more frequent resumption of sports and leisure activities.
Roche
Ghislaine
G
Laboratoire d'Ergonomie, Epidémiologie et Santé au Travail, Université d'Angers, Angers, France.
Ponthieux
Anne
A
Parot-Shinkel
Elsa
E
Jousset
Nathalie
N
Bontoux
Luc
L
Dubus
Valérie
V
Penneau-Fontbonne
Dominique
D
Roquelaure
Yves
Y
Legrand
Erick
E
Colin
Denis
D
Richard
Isabelle
I
Fanello
Serge
S
D000203:Activities of Daily Living; D000328:Adult; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012919:Social Behavior