Randomised controlled trial of exercise for low back pain: clinical outcomes, costs, and preferences
BMJPublished 31 July 1999Open access
J Klaber Moffett, David Torgerson, Sally EM Bell-Syer, David A. Jackson, H. Llewlyn-Phillips, Amanda Farrin
Citations375
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
An exercise programme led by a physiotherapist in the community and based on cognitive-behavioural principles helped patients to cope better with their pain and function better even one year later.
Abstract
The exercise class was more clinically effective than traditional general practitioner management, regardless of patient preference, and was cost effective.
Keywords
MedicineEconomics, Econometrics and Finance
Health PolicyEuroQol: the current state of play
5,829 Citations1996Richard Brooks
The EuroQol instrument is intended to complement other forms of quality of life measures, and it has been purposefully developed to generate a cardinal index of health, thus giving it considerable potential for use in economic evaluation.
SpineA Study of the Natural History of Back Pain
3,380 Citations1983Martín Roland, Richard Morris
The development and validation of a questionnaire designed to measure selfrated disability due to back pain is described, which is short, simple, sensitive, and reliable.
PainA Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability
3,128 Citations1993Gordon Waddell, Mary Newton +3 more
It is demonstrated that specific fear‐avoidance beliefs about work are strongly related to work loss due to low back pain, and these findings are incorporated into a biopsychosocial model of the cognitive, affective and behavioural influences inLow back pain and disability.
PainThe use of coping strategies in chronic low back pain patients: Relationship to patient characteristics and current adjustment
2,309 Citations1983Anne K. Rosenstiel, Francis J. Keefe
Cognitive and behavioral pain coping strategies were assessed by means of questionnaire in a sample of 61 chronic low back pain patients and three factors were found to be predictive of measures of behavioral and emotional adjustment to chronic pain above and beyond what may be predicted on the basis of patient history variables.
PainIncreasing the reliability and validity of pain intensity measurement in chronic pain patients
727 Citations1993Mark P. Jensen, Candace A. McFarland
The majority of patients did not report similar levels of pain from one day to another, and average pain scores calculated from ratings obtained from a single day were less stable than those calculated from Ratings obtained from multiple days, which underscores the importance of averaging multiple measures of pain intensity across time.
New England Journal of MedicineThe Treatment of Acute Low Back Pain — Bed Rest, Exercises, or Ordinary Activity?
617 Citations1995Antti Malmivaara, Unto Häkkinen +9 more
Among patients with acute low back pain, continuing ordinary activities within the limits permitted by the pain leads to more rapid recovery than either bed rest or back-mobilizing exercises.
New England Journal of MedicineA Comparison of Physical Therapy, Chiropractic Manipulation, and Provision of an Educational Booklet for the Treatment of Patients with Low Back Pain
616 Citations1998Daniel C. Cherkin, Richard A. Deyo +3 more
For patients with low back pain, the McKenzie method of physical therapy and chiropractic manipulation had similar effects and costs, and patients receiving these treatments had only marginally better outcomes than those receiving the minimal intervention of an educational booklet.
BMJRandomised controlled trial for evaluation of fitness programme for patients with chronic low back pain
301 Citations1995Helen Frost, J. A. Klaber Moffett +2 more
There is a role for supervised fitness programmes in the management of moderately disabled patients with chronic low back pain and a supervised fitness programme can help to reduce pain and disability and improve patients' confidence.
BMJRandomised comparison of chiropractic and hospital outpatient management for low back pain: results from extended follow up
234 Citations1995T W Meade, Sandra Dyer +2 more
The results confirm the findings of an earlier report that when chiropractic or hospital therapists treat patients with low back pain as they would in day to day practice those treated by chiropractor derive more benefit and long term satisfaction than those treating by hospitals.
SpineDeveloping a Valid and Reliable Measure of Health Outcome for Patients With Low Back Pain
188 Citations1994Danny Ruta, Andrew Garratt +2 more
A clinically based questionnaire, together with a general measure of health, can provide a valid and reliable package for the routine assessment of perceived health in patients with low back pain.
Journal of Manual & Manipulative Therapy(1996) Low Back Pain Evidence Review London: Royal College of General Practitioners
186 Citations1998Gordon Waddell, Gene Feder +3 more
SpineA Randomized, Placebo-Controlled Trial of Exercise Therapy in Patients with Acute Low Back Pain
154 Citations1993A. Faas, A. W. Chavannes +2 more
BMJ Quality & SafetyClinical Standards Advisory Group
151 Citations1994G. R. Higginson
"The four services you have selected are neonatal intensive care; cystic fibrosis; childhood leukaemia; and coronary artery bypass grafting."
PainA fitness programme for patients with chronic low back pain: 2-year follow-up of a randomised controlled trial
151 Citations1998Helen Frost, Sarah E Lamb +3 more
Clinical effectiveness of a fitness programme 2 years after treatment is demonstrated but this needs to be replicated in a larger study which should include a cost effectiveness analysis, further analysis of objective functional status and a placebo intervention group.
Behaviour Research and TherapyThe fear-avoidance model of exaggerated pain perception—II
142 Citations1983Peter D. Slade, J.D.G. Troup +2 more
Findings are in line with the prediction that personal pain history and personal coping strategies are relevant to the Fear-Avoidance Model of exaggerated pain perception and may therefore influence the adoption of an avoidance or a confrontation response by the patient with chronic back pain.
PainPain beliefs and the use of cognitive-behavioral coping strategies
140 Citations1991David A. Williams, Francis J. Keefe
Patients belonging to the group characterized by the belief that pain was enduring and mysterious were less likely to use cognitive coping strategies and more likely to catastrophize and rate their coping strategies as effective in controlling and decreasing pain than patients believing their pain to be understandable and of short duration.
Journal of Health Services Research & PolicyPatient Preferences in Randomised Trials: Threat or Opportunity?
140 Citations1996David Torgerson, Jennifer Klaber-Moffett +1 more
It is sometimes feasible to randomise patients to their less preferred treatment, thus allowing more robust statistical comparisons between randomised groups, and may make RCTs more rigorous and improve their external validity.
SpineA Randomized, Placebo-Controlled Trial of Exercise Therapy in Patients with Acute Low Back Pain
131 Citations1993A. Faas, A. W. Chavannes +2 more
It was concluded that exercise therapy for patients with acute low back pain has no advantage over usual care from the general practitioner.
Health PsychologyDifferential effects of avoidant and attentional coping strategies on adaptation to chronic and recent-onset pain.
108 Citations1990Judith A. Holmes, Crist A. Stevenson
The results supported this "time x strategy" hypothesis and implications for pain treatment programs are discussed, and suggestions are made for matching pain duration with patient coping style.
Diabetes CareDesigning Medical and Educational Intervention Studies: A review of some alternatives to conventional randomized controlled trials
107 Citations1993Clare Bradley
Designs selected are those that address the much neglected psychological issues involved in the recruitment of patients and allocation of patients to treatments within trials, and a range of alternative designs for medical and educational intervention studies considered.
Journal of the Royal Society of MedicineAre Randomized Controlled Trials Controlled? Patient Preferences and Unblind Trials
100 Citations1997Klim McPherson, Annie Britton +1 more
BMJIncorporating patient preferences into clinical trials
35 Citations1998Klim McPherson, Iain Chalmers
The difficulties of assessing the relative merits of treatments when patients have strong preferences for one of the alternatives are discussed, particularly as there is a widespread and unsupported belief that new treatments are likely to be superior to existing alternatives.
Scandinavian Journal of Behaviour TherapyRelationships Between Coping Strategies, Disability and Pain Levels in Patients with Chronic Low Back Pain
11 Citations1989Ann‐Mari Estlander, Kristiina Härkäpää
Differences in the reported use of pain coping strategies were studied in 104 chronic low back pain patients and indicated that the “preference order” for coping strategies is different in mild and in severe pain regardless of the subject's average level of pain and disability.
