title: A randomized controlled trial of the effects of muscle stretching, manual therapy and steroid injections in addition to 'stay active' care on health-related quality of life in acute or subacute low back pain.
abstract: OBJECTIVE
  To evaluate the health-related quality of life effects of muscle stretching, manual therapy and steroid injections in addition to 'stay active' care in acute or subacute low back pain patients.
  
  
  METHODS
  A randomized, controlled trial during 10 weeks with four treatment groups.
  
  
  METHODS
  Nine primary health care and one outpatient orthopaedic hospital department.
  
  
  METHODS
  One hundred and sixty patients with acute or subacute low back pain.
  
  
  METHODS
  Ten weeks of 'stay active' care only (group 1), or 'stay active' and muscle stretching (group 2), or 'stay active', muscle stretching and manual therapy (group 3), or 'stay active', muscle stretching, manual therapy and steroid injections (group 4).
  
  
  METHODS
  The Gothenburg Quality of Life instrument subscales Well-being score and Complaint score.
  
  
  RESULTS
  In a multivariate analysis adjusted for possible outcome affecting variables other than the treatment given Well-being score was 68.4 (12.5), 72.1 (12.4), 72,3 (12.4) and 72.7 (12.5) in groups 1-4, respectively (P for trend <0.05). There were significant trends for the well-being components patience (P < 0.005), energy (P < 0.05), mood (P < 0.05) and family situation (P < 0.05). The remaining two components and Complaint score showed a non-significant trend towards improvement.
  
  
  CONCLUSIONS
  The effects on health-related quality of life were greater the larger the number of treatment modalities available. The 'stay active' treatment group, with the most restricted number of modalities, had the most modest health-related quality of life improvement, while group 4 with the most generous choice of treatment modalities, had the greatest improvement.
authors.affiliation: Uppsala University, Department of Public Health and Caring Sciences, Family Medicine Section, Uppsala, Sweden. marie.grunnesjo@pubcare.uu.se
authors.forename: Marie I
authors.initials: MI
authors.lastname: Grunnesjö
authors.forename: Johan P
authors.initials: JP
authors.lastname: Bogefeldt
authors.forename: Stefan I E
authors.initials: SI
authors.lastname: Blomberg
authors.forename: Lars-Erik
authors.initials: LE
authors.lastname: Strender
authors.forename: Kurt F
authors.initials: KF
authors.lastname: Svärdsudd
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation* / Q000628:therapy; D008297:Male; D009043:Motor Activity / Q000502:physiology; D052580:Muscle Stretching Exercises / Q000379:methods*; D026201:Musculoskeletal Manipulations / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care; D010147:Pain Measurement; D011788:Quality of Life; D018582:Sick Leave / Q000706:statistics & numerical data; D018434:Sickness Impact Profile; D013256:Steroids / Q000008:administration & dosage* / Q000627:therapeutic use; D013548:Sweden; D016896:Treatment Outcome
chemical_list: D013256:Steroids