title: Effectiveness of a 'Global Postural Reeducation' program for persistent low back pain: a non-randomized controlled trial.
abstract: BACKGROUND
  The aim of this non-randomized controlled trial was to evaluate the effectiveness of a Global Postural Reeducation (GPR) program as compared to a Stabilization Exercise (SE) program in subjects with persistent low back pain (LBP) at short- and mid-term follow-up (ie. 3 and 6 months).
  
  
  METHODS
  According to inclusion and exclusion criteria, 100 patients with a primary complaint of persistent LBP were enrolled in the study: 50 were allocated to the GPR group and 50 to the SE group. Primary outcome measures were Roland and Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI). Secondary outcome measures were lumbar Visual Analogue Scale (VAS) and Fingertip-to-floor test (FFT). Data were collected at baseline and at 3/6 months by health care professionals unaware of the study. An intention to treat approach was used to analyze participants according to the group to which they were originally assigned.
  
  
  RESULTS
  Of the 100 patients initially included in the study, 78 patients completed the study: 42 in the GPR group and 36 in the SE group. At baseline, the two groups did not differ significantly with respect to gender, age, BMI and outcome measures. Comparing the differences between groups at short- and mid-term follow-up, the GPR group revealed a significant reduction (from baseline) in all outcome measures with respect to the SE group.The ordered logistic regression model showed an increased likelihood of definitive improvement (reduction from baseline of at least 30% in RMDQ and VAS scores) for the GPR group compared to the SE group (OR 3.9, 95% CI 2.7 to 5.7).
  
  
  CONCLUSIONS
  Our findings suggest that a GPR intervention in subjects with persistent LBP induces a greater improvement on pain and disability as compared to a SE program. These results must be confirmed by further studies with higher methodological standards, including randomization, larger sample size, longer follow-up and subgrouping of the LBP subjects.
  
  
  BACKGROUND
  NCT00789204.
authors.affiliation: Section of Occupational Medicine, Department of Internal Medicine, Geriatrics and Nephrology, University of Bologna, Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bonetti
authors.forename: Stefania
authors.initials: S
authors.lastname: Curti
authors.forename: Stefano
authors.initials: S
authors.lastname: Mattioli
authors.forename: Raffaele
authors.initials: R
authors.lastname: Mugnai
authors.forename: Carla
authors.initials: C
authors.lastname: Vanti
authors.forename: Francesco S
authors.initials: FS
authors.lastname: Violante
authors.forename: Paolo
authors.initials: P
authors.lastname: Pillastrini
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010353:Patient Education as Topic; D011187:Posture; D016896:Treatment Outcome