Physiotherapist-directed exercise, advice, or both for subacute low back pain: a randomized trial.

Pengel LH, Refshauge KM, Maher CG, Nicholas MK, Herbert RD, McNair P.

The objective of this study was to investigate the effectiveness of physiotherapist-prescribed exercise, advice, or both for subacute low back pain.  259 persons with subacute low back pain (>6 weeks and <3 months in duration) received 12 physiotherapist-directed exercise or sham exercise sessions and 3 physiotherapist-directed advice or sham advice sessions over 6 weeks. Primary outcomes were average pain over the past week (scale, 0 to 10), function (Patient-Specific Functional Scale), and global perceived effect (11-point scale) at 6 weeks and 12 months. Secondary outcomes were disability (Roland-Morris Disability Questionnaire), number of health care contacts, and depression (Depression Anxiety Stress Scales-21). The authors concluded that in participants with subacute low back pain, physiotherapist-directed exercise and advice were each slightly more effective than placebo at 6 weeks. The effect was greatest when the interventions were combined. At 12 months, the only effect that persisted was a small effect on participant-reported function.

Annals of Internal Medicine, 2007, 146(11), 787-796.

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