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Role of Physical Exercise in Low Back Pain Rehabilitation: A Randomized Controlled Trial of a Three-Month Exercise Program in Patients Who Have Completed Multidisciplinary Rehabilitation

Henchoz, Yves, MS*; de Goumoëns, Pierre, MD; Norberg, Michael, MD; Paillex, Roland, PT, MS; So, Alexander K. L., PhD, FRCP

doi: 10.1097/BRS.0b013e3181bf1de9
Randomized Trial

Study Design. Randomized controlled trial with 1-year follow-up.

Objective. To analyze the effects of an exercise program or routine follow-up on patients with chronic low back pain who have completed functional multidisciplinary rehabilitation. The short- and long-term outcome in terms of symptoms and physical and social functioning was compared.

Summary of Background Data. Systematic reviews have shown that functional multidisciplinary rehabilitation improves physical function and reduces pain in patients with chronic low back pain. However, long-term maintenance of these improvements is inconsistent and the role of exercise in achieving this goal is unclear.

Methods. One hundred five chronic patients with low back pain who had completed a 3-week functional multidisciplinary rehabilitation program were randomized to either a 3-month exercise program (n = 56) or routine follow-up (n = 49). The exercise program consisted of 24 training sessions during 12 weeks. Patients underwent evaluations of trunk muscle endurance, cardiovascular endurance, lumbar spine mobility (flexion and extension range-of-motion, fingertip-to-floor distance), pain and perceived functional ability at the beginning and the end of functional multidisciplinary rehabilitation, at the end of the exercise program (3 months) and at 1-year follow-up. Disability was also assessed at the same time points except at the beginning of functional multidisciplinary rehabilitation.

Results. At the end of the functional multidisciplinary rehabilitation, both groups improved significantly in all physical parameters except flexion and extension range-of-motion. At the 3 month and 1 year follow-up, both groups maintained improvements in all parameters except for cardiovascular endurance. Only the exercise program group improved in disability score and trunk muscle endurance. No differences between groups were found.

Conclusion. A favorable long-term outcome was observed after functional multidisciplinary rehabilitation in both patient groups. Patients who participated in an exercise program obtained some additional benefits. The relevance of these benefits to overall health status need to be further investigated.

After functional multidisciplinary rehabilitation, patients with chronic low back pain receiving either a 3-month exercise program or routine follow-up maintained their improvements at short- and long-term. The exercise program offered additional benefits on disability and trunk muscle endurance outcomes.

From the *Institut des sciences du sport et de l'éducation physique, Université de Lausanne, Suisse; †Service de Rhumatologie, Département de l'Appareil Locomoteur, Université de Lausanne, Suisse; and ‡Direction des soins, CHUV, Lausanne, Suisse.

Acknowledgment date: February 17, 2009. First revision date: June 4, 2009. Second revision date: August 5, 2009. Acceptance date: August 7, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Yves Henchoz, MS, Institut des sciences du sport et de l'éducation physique, Université de Lausanne, Centre administratif de Vidy, 1015 Lausanne, Suisse; E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.