Affiliations: [a] Physical Therapy Program, College of St. Scholastica, Duluth, MN, USA | [b] Sports Medicine, Essentia Health, Duluth, MN, USA | [c] Occupational Medicine, Essentia Health, Duluth, MN, USA
Correspondence:
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Corresponding author: Jena B. Ogston, Physical Therapy Program, College of St. Scholastica, Duluth, MN, USA. Tel.: +1 218 733 2216; Fax: +1 218 723 6629; E-mail:jogston@css.edu
Abstract: BACKGROUND: Approaches in the treatment of general chronic low
back pain (CLBP) are multifaceted relative to specific interventions. In the
past, passive interventions have commonly been employed with little evidence
to support their effectiveness. Recent reviews suggest a focus on active
exercises programs that includes pain education and cognitive behavioral
therapy. OBJECTIVE: To investigate the outcomes of CLBP patients and
describe the approach in persons undergoing a group spinal rehabilitation
program using graded exercise, and operant conditioning. METHODS: Adult patients with CLBP participated in a twice weekly 90
minute exercise sessions for 8-weeks (n= 201). The program consisted of
behavioral education, stretching, aerobic exercises, graded
progressive resistance exercise, MedX isotonic strengthening, and functional
bending lifting task exercises. RESULTS: A total of 201 patient records were evaluated where the
overall ODI improvement was 13.2% (± 14.0) (p< 0.001). There were
significant and clinically meaningful improvements in flexibility, VAS,
functional lifting tasks (p< 0.001), and lumbar extension strength (p= 0.01)
at 8-week follow-up. Questionnaires were delivered via mail with a 21%
return rate revealed sustained improvements. CONCLUSION: CLBP patients undergoing an 8-week intensive exercise
approach incorporating both behavioral and physical conditioning principles
showed both significant and clinically significant improvements in this
observational case series. Long-term benefits were also seen in both the 6
and 12 month follow-up questionnaires although further
investigation is warranted due to limited survey return rate and study design.
Keywords: Kinesiophobia, graded exercise, group therapy, Oswestry, operant conditioning, rehabilitation, chronic low back pain
