Oral Presentation ARA-NSW 2020 - 42nd Annual NSW Branch Meeting

Exercise and education may not prevent recurrence of low back pain: A randomised controlled trial (#31)

Giovanni Ferreira 1 2 , Christine Lin 1 2 , Matthew Stevens 3 , Mark Hancock 4 , Jane Latimer 1 2 , Patrick Kelly 1 , Trish Wisbey-Roth 5 , Christopher Maher 1 2
  1. The University of Sydney, Camperdown, NSW, Australia
  2. Institute for Musculoskeletal Health, Institute for Musculoskeletal Health, Sydney Local Health District & The University of Sydney, Sydney, NSW, Australia
  3. The National Research Centre for the Working Environment, Copenhagen, Denmark
  4. Department of Health Professions, Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
  5. Bounce Back Active Rehabilitation Systems, Sydney, NSW, Australia

Question To determine the effectiveness of an exercise and education program compared to a minimal intervention in preventing recurrence of low back pain (LBP) in people recently recovered from an episode of LBP.

Methods: Superiority, pragmatic, parallel group, outcomes assessor-blinded randomised controlled trial with one-year follow-up conducted between January 2016 and December 2018 in 11 physical therapy practices in Sydney and Wollongong, Australia. Participants aged 18 years or older recovered from a previous episode of LBP within the previous week were recruited from primary care practices and the community and randomised to an exercise and education or control groups. The exercise and education intervention had a duration of 12 weeks and included eight supervised exercise sessions, and 3 one-on-one sessions. Participants in the control group received a minimal intervention delivered by a physical therapist consisting of a single session of advice on self-management. The primary outcome was time to recurrence of LBP during the one-year follow-up. Time to recurrence of LBP leading to activity limitation, care seeking, and work absence were secondary outcomes. Data were analysed with Cox regression models using intention-to-treat principles.

Results: Of the 111 participants recruited, 55 (49.5%) were female, and the mean (SD) age was 50.3 (13.1). At the end of the study period, data completeness was 84.2%. Thirty-six (63.2%) participants in the exercise and education group, and 31 (57.4%) in the control group had a recurrence of low back pain. There was no statistically significant difference in time to recurrence of pain between groups (HR 1.09, 95% CI 0.7 to 1.8). There was no statistically significant effect for any of the secondary outcomes.

Conclusions: Among people recently recovered from LBP, exercise and education may not reduce risk of recurrence.

Trial registration: ACTRN12615000939594