Low Back Pain, Recurrent Clinical Trial
Official title:
Patient Preference Effect on Adherence and Efficacy of Exercise for Non-specific Low Back Pain
Background: Low back pain, mainly nonspecific (NSLBP) is a major cause of pain and disability
worldwide. Exercise therapy (ET) is considered as the first line treatment, and it is one of
the treatment modalities most commonly used by physiotherapists. Yet, ET is reliant on the
adherence of patients to its various components. Research has demonstrated a positive
relationship between adherence to rehabilitation programs and recovery from a variety of
musculoskeletal conditions. Therefore, factors that strengthen adherence to ET may increase
its efficacy for NSLBP. Converging evidence from recent studies suggest that control and
choice may increase adherence to various treatments.
Therefore, the purpose of this study is to evaluate the effect of patient choice and
preference on adherence and efficacy of exercise for recovery from NSLBP.
Design: Matched case control study. Participants: Fifty subjects with chronic (>3 months)
NSLBP. Twenty-five participants will be allocated to exercise by preference group, and 25
aged and gender controls will be allocated to exercise group.
Inclusion criteria:
1. Non-specific low back pain (pain or discomfort in the lumbosacral area, with or without
symptoms to the lower extremities), diagnosed by general physician or orthopedic
surgeon.
2. Age 18-35
3. Chronic pain (greater than 3 months' duration).
Exclusion Criteria:
1. Specific cause for LBP (rheumatic diseases, tumors, fractures, fibromyalgia, previous
spinal surgery, pregnancy, low back pain after car or work accidents).
2. Previous (last three years) ET treatment for NSLBP.
3. Regularly performing exercise more than WHO's recommendation:
- 150 minutes of moderate-intensity aerobic physical activity throughout the week or
at least 75 minutes of vigorous-intensity aerobic physical activity throughout the
week or an equivalent combination of moderate- and vigorous-intensity activity.
- Muscle-strengthening activities should be done involving major muscle groups on 2
or more days a week.
Procedure: After initial assessment, participants in the intervention group will be asked to
choose 3-4 items from a list of 10 general exercises - intended for treatment of low back
pain. Each matched participant in the control group will receive the same exercise (without
the option to choose). Participants will be instructed to perform their exercises three times
a week, for a period of four weeks (12 sessions total).
Outcomes: Oswestry Disability Index (ODI) Henry-Eckert Performance Assessment Tool (HEPA)
Both measurements will be taken on the first and last meeting. Additionally, each participant
will fill a personal weekly exercise log (selecting between complete \ incomplete \ lack of
execution) - sent by e-mail.
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