The short-term effects of graded activity versus physiotherapy in patients with chronic low back pain: A randomized controlled trial.

Chronic back pain in a worldwide health problem associated with disability, reduced quality of life and increasing days off work. Therapies such as graded activity, cognitive behavioural therapy and targeted exercise are common treatments. However recent evidence has challenged the use of graded activity for management of chronic nonspecific low back pain. A total of 66 patients with chronic nonspecific low back pain were randomized to perform either graded activity (moderate intensity treadmill walking, brief education and strength exercises) or physiotherapy (strengthening, stretching and motor control) through individual sessions twice a week or six weeks. The primary measures were intensity of pain (Pain Numerical Rating Scale) and disability (Rolland Morris Disability Questionnaire).

After six weeks, significant improvements have been observed in all outcome measures of both groups, with a non-significant difference between the groups. For intensity of pain (mean difference = 0.1 points, 95% confidence interval [CI] = -1.1-1.3) and disability (mean difference = 0.8 points, 95% confidence interval [CI] = -2.6-4.2). No differences were found in the remaining outcomes. The results of this study suggest that graded activity and physiotherapy showed to be effective and have similar effects for patients with chronic nonspecific low back pain.