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Long-term exercise adherence after intensive rehabilitation for chronic low back pain


Medicine & Science in Sports & Exercise: March 2000 - Volume 32 - Issue 3 - p 551-557
CLINICAL SCIENCES: Clinical Investigation

HARTIGAN, C., J. RAINVILLE, J. B. SOBEL, and M. HIPONA. Long-term exercise adherence after intensive rehabilitation for chronic low back pain. Med. Sci. Sports Exerc., Vol. 32, No. 3, pp. 551–557, 2000.

Purpose: The purpose of this study was to examine exercise compliance in patients with chronic low back pain (CLBP) after participation in an intensive spine rehabilitation program.

Methods: Exercise behaviors in 122 consecutive subjects with CLBP who completed a program of quota based exercise were examined. Frequency per week of performance of four exercise activities, Oswestry disability scores, and visual analog scale (VAS) scores were assessed at evaluation, 3-month, and 12-month follow-up by patient-completed questionnaires.

Results: Percentage of patients responding to initial, 3-month, and 12-month questionnaires were 100%, 86%, and 71%, respectively. Frequencies of exercise behaviors were compared by Wilcoxon signed-rank test and were found to increase significantly between evaluation and 3 months (P < 0.000), and evaluation and 12-month follow-up (P < 0.000). The percentages of patients reporting three or more times weekly performance of the following activities at evaluation and at three month follow-up, respectively, were: 1) stretching for the back and legs, 35% and 93%; 2) aerobic exercise, 44% and 87%; 3) back-strengthening exercises, 15% and 82%; and, 4) weight training, 6% and 71%. Evaluation and follow-up Oswestry disability and visual analog scale (VAS) scores for back pain were compared using Student’s t-test. Significant improvements (P < 0.000) were noted for each of these scales at 3-month follow-up that were maintained at 12-month follow-up.

Conclusion: It is concluded that exercise behaviors can be increased and maintained in CLBP patients without adversely affecting pain or function.

The Department of Rehabilitation Medicine, Tufts University School of Medicine, Boston, MA

Submitted for publication September 1997.

Accepted for publication January 1999.

Address for correspondence: Carol Hartigan, M.D., The Spine Service, New England Baptist Bone and Joint Institute, 125 Parker Hill Avenue, Boston, MA 02120. E-mail:

©2000The American College of Sports Medicine