Finally, an excellent study on exercise & LBP!

When it comes to the management of acute or chronic low back pain (LBP), many published studies have concluded that “any exercise will do” . The medical consensus is that patients with acute LBP get better with the “Don�??t worry, be happy and just move” prescription.

Many physicians and orthopaedic surgeons will also agree with these studies that demonstrate specific exercises are a waste of time…all patients need is GENERAL EXRCISES, which can technically be prescribed by anyone!

The purpose of this randomized controlled trial was to determine if subgroups of patients with LBP respond differently to contrasting exercise prescriptions.

In this study, a total of 312 acute, sub-acute, and chronic patients, including LBP-only and sciatica, underwent a mechanical assessment classifying them by their pain response, specifically eliciting either a “directional preference” or no directional prefernce.

(i.e. patients were considered to have direction preference, if their symptoms improved or centralized with lumbar flexion, extension, or side-glide/rotation tests)

A preferred direction was elicited in 74% of subjects.

Only the subjects with a preferred direction were randomized to:

1) Directional exercises “matching” their preferred direction

2) Exercises directionally “opposite” their preferred direction
(In other words, if the assessment showed that a patient preferred flexion movements, they were give a home exercise program focusing on extension or visa versa)

3) “Non-directional” exercises.
(provided with general exercises)

Outcome measures included pain intensity, location, disability, medication use, degree of recovery, depression, and work interference.

Interestingly, one third of both the opposite and non-directionally treated subjects withdrew within 2 weeks because of no improvement or worsening (no matched subject withdrew).

Posted on: June 09, 2005

Categories: Lumbar Spine

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