OBJECTIVE: To determine the short-term and long-term effects of intermittent follow-up Cesar exercise therapy in patients with subacute or chronic aspecific low back pain who have completed a standard 3-month course of Cesar exercise therapy. METHOD: Randomized, controlled trial with a 1.5-year follow-up. After standard treatment by a Cesar exercise therapist (about twelve sessions in 3 months), patients with subacute or chronic low back pain were randomized to an intervention group (n = 96) receiving intermittent follow-up treatment (about six follow-up sessions in 6 months) or to a control group (n = 105) without further treatment. Questionnaires were completed before randomization (after completion of standard treatment) and 6 and i8 months after randomization. The primary outcome measure was self-reported recovery from back pain. Secondary outcome measures were disability, intensity and duration of back pain, and general health. RESULTS: Six months after randomization, the intermittent follow-up treatment showed a statistically significant improvement in self-reported recovery (intervention group, from 83% at baseline to 86% at 6 months; control group, from 8% at baseline to 75% at 6 months), disability, and duration of back pain. Eighteen months after randomization, no differences between the groups were detected: in both groups 84% of the patients reported that they had recovered. CONCLUSION: This study shows that intermittent sessions of Cesar exercise therapy have an immediate positive effect on the recovery of patients with subacute or chronic aspecific low back pain who have already received a standard course of Cesar therapy. However, this beneficial effect is not seen 12 months later. Thus there is no evidence that intermittent therapy makes patients better able to manage or prevent symptoms.

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