title: Efficacy of graded activity versus supervised exercises in patients with chronic non-specific low back pain: protocol of a randomised controlled trial.
abstract: BACKGROUND
  Low back pain is a relevant public health problem, being an important cause of work absenteeism worldwide, as well as affecting the quality of life of sufferers and their individual functional performances. Supervised active physical routines and of cognitive-behavioral therapies are recommended for the treatment of chronic Low back pain, although evidence to support the effectiveness of different techniques is missing. Accordingly, the aim of this study is to contrast the effectiveness of two types of exercises, graded activity or supervised, in decreasing symptoms of chronic low back pain.
  
  
  METHODS
  Sample will consist of 66 patients, blindly allocated into one of two groups: 1) Graded activity which, based on an operant approach, will use time-contingent methods aiming to increase participants' activity levels; 2) Supervised exercise, where participants will be trained for strengthening, stretching, and motor control targeting different muscle groups. Interventions will last one hour, and will happen twice a week for 6  weeks. Outcomes (pain, disability, quality of life, global perceived effect, return to work, physical activity, physical capacity, and kinesiophobia) will be assessed at baseline, at treatment end, and three and six months after treatment end. Data collection will be conducted by an investigator blinded to treatment allocation.
  
  
  CONCLUSIONS
  This project describes the randomisation method that will be used to compare the effectiveness of two different treatments for chronic low back pain: graded activity and supervised exercises. Since optimal approach for patients with chronic back pain have yet not been defined based on evidence, good quality studies on the subject are necessary.
  
  
  BACKGROUND
  NCT01719276.
authors: Department of Physical Therapy, Communication Science & Disorders, Occupational Therapy, University of São Paulo, São Paulo, Brazil. m.magalhaes@usp.br
authors: Mauricio Oliveira
authors: MO
authors: Magalhaes
authors: Fábio Jorge Renovato
authors: FJ
authors: França
authors: Thomaz Nogueira
authors: TN
authors: Burke
authors: Luiz Armando Vidal
authors: LA
authors: Ramos
authors: Ana Paula
authors: AP
authors: de Moura Campos Carvalho e Silva
authors: Gabriel Peixoto Leao
authors: GP
authors: Almeida
authors: Susan Lee King
authors: SL
authors: Yuan
authors: Amélia Pasqual
authors: AP
authors: Marques
mesh_terms: D059350:Chronic Pain / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D009043:Motor Activity / Q000502:physiology; D010147:Pain Measurement / Q000379:methods*; D016896:Treatment Outcome