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A comparison of high intensity aerobic exercise and passive modalities for the treatment of workers with chronic low back pain: a randomized, controlled trial [with consumer summary]
Murtezani A, Hundozi H, Orovcanec N, Sllamniku S, Osmani T
European Journal of Physical and Rehabilitation Medicine 2011 Sep;47(3):359-366
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

In recent years, disability due to chronic low back pain (LBP) has steadily increased in all industrialized countries. In the treatment of chronic LBP, the objectives are to reduce pain, to improve function and minimize avoiding behavior. Exercise therapy is a management strategy that is widely used as a treatment for LBP. AIM: The aim of this study was to investigate the effects of high- intensity aerobic exercise on pain, disability, anxiety or depression in people with chronic LBP. DESIGN: This was a randomized controlled trial. SETTING: Institute of Occupational Medicine, Department of Physical Medicine and Rehabilitation Outpatient Ward. POPULATION: Kosovo power plant workers. METHODS: Participants with chronic low back pain, excluding those with "red flag" criteria were assigned randomly to one of the two treatment groups: an aerobic exercise group (n = 50), and an passive modalities group (n = 51). Data on low back pain intensity (visual analogue scale), disability (Oswestry Low Back Pain Disability Questionnaire), fingertip-to-floor distance, and psychosocial factors (Hospital Anxiety and Depression Scale) were collected at baseline and after 12-weeks follow-up points. RESULTS: At 12-week follow-up, significant improvements in pain intensity and disability had occurred in the exercise group. We have verified significant improvements in comparison with basic values in pain intensity (6 +/- 2.6 versus 2 +/- 1.7, diff of mean 3.9, p < 0.001), disability (31 +/- 17.4 versus 15.8 +/- 12.7, diff of mean 15.2, p < 0.001), anxiety and depression (21.1 +/- 8.2 versus 14 +/- 6.7, diff of mean 7.1, p < 0.001), and fingertip- to-floor distance (27.8 +/- 9.1 versus 14.2 +/- 5.7, p < 0.001). Whereas, differences in average pain, disability, anxiety and depression and fingertip-to-floor distance are not significant in the control group. CONCLUSION: High intensity aerobic exercise reduces pain, disability and psychological strain in patients with chronic low back pain.

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