BACKGROUND: Low back pain (LBP) is an important health problem in all developed countries and is associated with high levels of disability. Evidence-based clinical practice guidelines usually recommend different physical therapy interventions to manage this condition. However, those interventions usually result in small to moderate clinical effects. Recent studies suggest that interventions based on subgroup classifications may improve the effect sizes compared to rehabilitation programs where the same interventions were applied to all patients. OBJECTIVE: To investigate the efficacy of treatment based on a movement system impairment (MSI) based classification model for patients with chronic LBP compared to general exercise. The primary outcomes will be pain intensity and disability at two months after randomization. DESIGN: The study is a two-arm, prospectively registered, randomized controlled trial with a blinded assessor. SETTING: The study setting will be a university physical therapy clinic in Brazil. PARTICIPANTS: A total of 148 subjects with chronic LBP will participate in the study. INTERVENTION: Subjects will be randomly allocated to participate in an 8-week treatment based upon the MSI based classification or a general exercise program of stretching and strengthening exercises. MEASUREMENTS: Pain intensity, disability and global impression of recovery will be assessed by a blinded assessor at baseline and at follow up appointments after treatment (two months) and four and six months after randomization. LIMITATION: Therapists will not be blinded. CONCLUSIONS: The results of this study may contribute to a better understanding of the efficacy of treatments based on classification of subjects with chronic LBP into subgroups.
AD - D.C. Azevedo, PT, MSc, Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, and Physical Therapy Department, Pontificia Universidade Catolica de Minas Gerais, Dom Jose Gaspar 500, Belo Horizonte, MG, Brazil 30535-901.BACKGROUND: Low back pain (LBP) is an important health problem in all developed countries and is associated with high levels of disability. Evidence-based clinical practice guidelines usually recommend different physical therapy interventions to manage this condition. However, those interventions usually result in small to moderate clinical effects. Recent studies suggest that interventions based on subgroup classifications may improve the effect sizes compared to rehabilitation programs where the same interventions were applied to all patients. OBJECTIVE: To investigate the efficacy of treatment based on a movement system impairment (MSI) based classification model for patients with chronic LBP compared to general exercise. The primary outcomes will be pain intensity and disability at two months after randomization. DESIGN: The study is a two-arm, prospectively registered, randomized controlled trial with a blinded assessor. SETTING: The study setting will be a university physical therapy clinic in Brazil. PARTICIPANTS: A total of 148 subjects with chronic LBP will participate in the study. INTERVENTION: Subjects will be randomly allocated to participate in an 8-week treatment based upon the MSI based classification or a general exercise program of stretching and strengthening exercises. MEASUREMENTS: Pain intensity, disability and global impression of recovery will be assessed by a blinded assessor at baseline and at follow up appointments after treatment (two months) and four and six months after randomization. LIMITATION: Therapists will not be blinded. CONCLUSIONS: The results of this study may contribute to a better understanding of the efficacy of treatments based on classification of subjects with chronic LBP into subgroups.
PY - 2015 SE - 1287-94 SN - 1538-6724 (Electronic)