Graded activity in patients with chronic low back pain
Chronic non-specific low back pain accounts for 95% of cases of low back pain and is characterized by a defined ethology and the presence of symptoms for at least 12 weeks. In an attempt to reduce the impact associated with chronic non-specific low back pain certain treatments have been recommended. One of the approaches for therapy is the cognitive behavioural model.
This assumes that disability is determined not only by the underlying pathology, but also by social, cognitive, emotional, and behavioural factors. The graded activity program, based on the cognitive behavioural therapy was developed based on studies suggesting that cognitive-behavioural aspects and operant conditioning principles can be used to reinforce healthy behaviours.
Graded activity aims to reduce pain and disability by addressing pain-related fear, kinesiophobia, and unhelpful beliefs and behaviours about back pain while correcting physical impairments such as reduced endurance, muscle strength, and balance.
The purpose of this study was to compare the effectiveness of graded activity and physiotherapy in patients with chronic nonspecific low back pain. Both groups received intervention during six weeks; the physiotherapy group received two individual therapy sessions each week. The graded activity intervention consisted of treadmill walking, a brief education and strength exercises; the physiotherapy intervention included motor control and strengthening exercises and stretching.
The graded activity intervention was found to be similarly effective to physiotherapy exercises, and no significant differences between the groups were observed after six weeks of treatment.
> From: Magalhaes et al., Man Ther (2015) 7(Epub ahead of print). All rights reserved to Elsevier Ltd. Click here for the Pubmed summary.