OBJECTIVE: To evaluate the effectiveness of specific lumbar extensor training compared with regular physical therapy (PT) in workers with nonspecific nonacute low back pain (LBP). DESIGN: A multicenter randomized controlled trial with 1-year follow-up. SETTING: PT department in (military primary care) health centers. PARTICIPANTS: Predominantly male soldiers (N = 129) with 4 weeks or more of low back complaints who were referred by the health center's general practitioner for PT (mean age 35.9 +/- 10.8 y; range 20 to 56 y), of whom 127 randomized participants were included in the analyses. One patient withdrew because of adverse effects during treatment. INTERVENTIONS: Participants were assigned to 1 of 2 treatment programs: (1) a 10-week device-supported isolated lumbar extension training, twice a week, or (2) regular PT, mainly consisting of exercise therapy and aerobic activities. MAIN OUTCOME MEASURES: Functional status (Roland-Morris Disability Questionnaire, Patient-Specific Functional Scale) and global perceived effect were assessed in the short term (5 wk, 10 wk) and long term (6 mo, 12 mo). RESULTS: Both groups showed a favorable development in main outcomes over time: short-term improvements (after 10 weeks of treatment) remained stable or even slightly increased throughout the 12-month follow-up. No significant differences between the 2 groups were shown for any of the outcome measures, at any time. CONCLUSIONS: Consistent with prior evidence, specific back strengthening does not seem to offer incremental benefits in LBP management compared with regular PT care that mainly consists of general exercise therapy.

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