• Spine · May 1999

    Multicenter Study Comparative Study Clinical Trial

    Restorative exercise for clinical low back pain. A prospective two-center study with 1-year follow-up.

    • S Leggett, V Mooney, L N Matheson, B Nelson, T Dreisinger, J Van Zytveld, and L Vie.
    • U.S. Orthopedics, Little Rock, Arkansas, USA.
    • Spine. 1999 May 1; 24 (9): 889-98.

    Study DesignA comparison of treatment of 412 patients with chronic back pain at two separate centers using the same treatment protocols and outcome measures. Outcome was defined by specific strength testing; Short Form-36 scores at intake, discharge, and 1-year follow-up; self-appraisal of improvement at discharge and in a 1-year follow-up; and reuse of health care services after discharge.ObjectivesTo investigate the efficacy of standardized treatment methods using isolated lumbar strength testing and strengthening based on progressive protocols using specific equipment. Comparison of results should clarify the effect of the treatment center versus the efficacy of standardized protocols.Summary Of Background DataThere has been little support in the scientific literature for exercise programs based on standardized protocols. The use of specialized equipment to achieve intense specific exercise also has been poorly supported. Overall health benefit has not often been related to specific improvement in strength.MethodsMore than 400 individuals with chronic back pain were evaluated at the initiation of treatment, discharge, and 1 year after discharge. Measures of efficacy were based on Short Form-36 scores, self-appraisal of improvement, and reuse of health care services after discharge. Study participants were patients with chronic back pain consecutively referred to each treatment site and underwritten by a variety of payers, including workers' compensation, Medicare, and private insurance.ResultsOverall response during the course of the program and at 1-year follow-up was similar between the two centers. Similar proportions of participants at each site demonstrated improvement in SF-36 scores, self-appraisal of improvement, and reuse of health care services.ConclusionsStandardized protocols using specific strength and measurement equipment can achieve similar benefits at different sites.

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