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Randomised controlled trial of physiotherapy compared with advice for low back pain

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Frost, Helen, Lamb, S. E. (Sallie E.), Doll, Helen A., Taffe Carver, Patricia and Stewart-Brown, Sarah L.. (2004) Randomised controlled trial of physiotherapy compared with advice for low back pain. BMJ, Vol.329 (No.7468). pp. 708-711. ISSN 0959-535X

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Official URL: http://dx.doi.org/10.1136/bmj.38216.868808.7C

Abstract

Objective To measure the effectiveness of routine physiotherapy compared with an assessment session and advice from a physiotherapist for patients with low back pain. Design Pragmatic, multicentre, randomised controlled trial. Setting Seven NHS physiotherapy departments. Participants 286 patients with low back pain of more than six weeks' duration. Intervention Routine physiotherapy or advice on remaining active from a physiotherapist. Main outcome measures Primary outcome was scores on the Oswestry disability index at 12 months. Secondary outcomes were scores on the Oswestry disability index (2 and 6 months), scores on the Roland and Morris disability questionnaire and SF-36 (2, 6 and 12 months), and patient perceived benefit from treatment (2, 6, and 12 months). Results 200 of 286 patients (70%) provided follow up information at 12 months. Patients in the therapy group reported enhanced perceptions of benefit, but there was no evidence of a long term effect of physiotherapy in either disease specific or generic outcome measures (mean difference in change in Oswestry disability index scores at 12 months -1.0%, 95% confidence interval -3.7% to 1.6%). The most common treatments were low velocity spinal joint mobilisation techniques (72%, 104 of 144 patients) and lumbar spine mobility and abdominal strengthening exercises (94%, 136 patients). Conclusion Routine physiotherapy seemed to be no more effective than one session of assessment and advice from a physiotherapist.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Backache -- Treatment, Backache -- Physical therapy
Journal or Publication Title:	BMJ
Publisher:	BMJ Group
ISSN:	0959-535X
Date:	17 September 2004
Volume:	Vol.329
Number:	No.7468
Number of Pages:	16
Page Range:	pp. 708-711
Identification Number:	10.1136/bmj.38216.868808.7C
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Arthritis Research Campaign (Organization)
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URI:	http://wrap.warwick.ac.uk/id/eprint/8045