PM&R
Volume 1, Issue 2 , Pages 137-146 , February 2009

Functional Movement Training for Recurrent Low Back Pain: Lessons From a Pilot Randomized Controlled Trial

  • Margaret L. Schenkman, PhD, PT

      Affiliations

    • Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Aurora, CO⁎
    • ,
  • Sharon Jordan, MA, PT

      Affiliations

    • Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Aurora, CO⁎
    • ,
  • Venu Akuthota, MD

      Affiliations

    • The Spine Center at University of Colorado Hospital, Department of Physical Medicine and Rehabilitation, University of Colorado Denver School of Medicine, PO Box 6508, Mail Stop F-493, Aurora, CO 80045⁎
    • Corresponding Author InformationAddress correspondence to V.A.
    • ,
  • Matthew Roman, PT, OMT

      Affiliations

    • Department of Physical Therapy, Duke University Medical School, Durham, NC⁎
    • ,
  • Wendy M. Kohrt, PhD

      Affiliations

    • Division of Geriatric Medicine, Department of Medicine, University of Colorado Denver, Aurora, CO⁎
    • ,
  • Thomas Hearty, MD, DPT

      Affiliations

    • Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Aurora, CO⁎
    • ,
  • Catherine Cleary, PT

      Affiliations

    • The Spine Center at University of Colorado Hospital, Aurora, CO⁎
    • ,
  • Karen Maloney Backstrom, MS, PT, OCS

      Affiliations

    • Private Practice, Denver, CO⁎

Received 7 March 2008 ,Accepted 13 October 2008.

References 

  1. Andersson G. Epidemiology of low back pain. Acta Orthop Scand. 1998;69(suppl 281):28–31
  2. Andersson G. The epidemiology of spinal disorders. In:  Frymoyer J editors. The Adult Spine: Principles and Practice. Vol. 1:New York, NY: Raven Press; 1991;p. 107–146
  3. Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-lack pain and its related medical care in the United States. Spine. 1987;12:264–268
  4. Hart LG, Deyo RA, Cherkin DC. Physician office visits for low back pain (Frequency, clinical evaluation, and treatment patterns from a U.S. National Survey). Spine. 1995;20:11–19
  5. Skargren EI, Carlsson PG, Oberg BE. One-year follow-up comparison of the cost and effectiveness of chiropractic and physiotherapy as primary management for low back pain. Spine. 1998;23(17):1875–1883
  6. Hadler NM, Carey TS. Low back pain: an intermittent and remittent predicament of life. Ann Rheum Dis. 1998;57(1):1–2
  7. van Tulder M, Koes B, Bombardier C. Low back pain. Best Pract Res Clin Rheumatol. 2002;16(5):761–775
  8. Woby SR, Urmston M, Watson SJ. Self-efficacy mediates the relation between pain-related fear and outcome in chronic low back pain patients. Eur J Pain. 2007;11(7):711–718
  9. Balamurugan A, Onsfeldt R, Hughes T, Phillips M. Diabetes self-management education program for Medicaid patients. Diabetes Educ. 2006;30(6):893–900
  10. Damush TM, Weinberger M, Perkins S, Rao JK, Tierney WM, Qi R, et al. Randomized trial of self-management program for primary care patients with acute low back pain. Arthritis Rheum. 2003;49(2):179–186
  11. Lorig K, Gonzalez VM, Laurent DD, Morgan L, Laris BA. Arthritis self-management program variations: three studies. Arthritis Care Res. 1998;11:448–454
  12. Wennemer HK, Borg-Stein J, Gomba L, Delaney B, Rothmund A, Barlow D, et al. Functionally oriented rehabilitation program for patients with fibromyalgia: preliminary results. Am J Phys Med Rehab. 2006;85:659–666
  13. Van Tulder MW, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain (A systematic review of randomized controlled trials of the most common interventions). Spine. 1997;22:2128–2156
  14. Mannion A, Muntener M, Taimela S, Dvorak J. A randomized clinical trial of three active therapies for chronic low back pain. Spine. 1999;24:2435–2448
  15. Cairns MC, Foster NE, Wright C. Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain. Spine. 2006;31:E670–E681
  16. O'Sullivan PB, Twomey LT, Allison GT. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiographic diagnosis of spondylolysis and spondylolisthesis. Spine. 1997;22(24):2959–2967
  17. Hayden JA, van Tulder MW, Malmivaara A, Koes B. Exercise therapy for treatment of non-specific low back pain. Cochrane Database. 2005;July
  18. Roland M, Waddel G, Moffett JK. The Back Book. Norwich, UK: The Stationary Office; 1999;
  19. Richardson C, Jull G, Hodges P, Hides J. Therapeutic exercise for spinal segmental stabilization in low back pain: scientific basis and clinical approach. Edinburgh, UK: Churchill Livingstone; 1999;
  20. Akuthota V, Ferreiro A, Moore T, Fredericson M. Core stability exercise concepts. Curr Sports Med Rep. 2008;7(1):39–44
  21. Roland M, Morris R. A study of the natural history of back pain: Part I (Development of a reliable and sensitive measure disability in low-back pain). Spine. 1983;8:141–144
  22. Stewart TJ, Taylor AE, Foy MA, Fogg AJB. Responsiveness of common outcome measures for patients with low back pain. Spine. 1999;24:1805–1812
  23. Osterweis M, Kleinman A, Mechanic D Institute of Medicine's Committee on Pain, Disability, and Chronic Illness. Behavior, Pain, Disability: Clinical, Behavioral, and Public Policy Perspectives. Washington, DC: National Academy; 1987;
  24. Stratford PW, Binkley J, Solomon P, Finch E, Gill C, Moreland J. Defining the minimum level of detectable change for the Roland-Morris Questionnaire. Phys Ther. 1996;76:359–365
  25. Beurskens AJHM, de Vet HCW, Koke AJA. Responsiveness of functional status in low back pain: a comparison of different instruments. Pain. 1996;65:71–76
  26. Cress ME. Quantifying physical functional performance in older adults. Muscle Nerve. 1997;5:S17–S20
  27. Cress M, Buchner D, Questad K, Esselman P, de Lateur B, Schwartz R. Continuous scale physical performance in healthy adults: a validation study. Arch Phys Med Rehabil. 1996;77:1243–1250
  28. Cress ME, Buchner DM, Questad KA, Esselman PC, deLateur BJ, Schwartz RS. Exercise: effects on physical functional performance in independent older adults. J Gerontol A Biol Sci Med Sci. 1999;54A:M242–M248
  29. Miszko TA, Cress ME, Slade JM, Covey CJ, Agrawal SK, Doerr CE. Effect of strength and power training on physical function in community-dwelling older adults. J Gerontol Med Sci. 2003;58(2):171–175
  30. Schenkman M, Cutson TM, Kuchibhatla M, Scott B, Cress ME. Application of the Continuous Scale Physical Functional Performance Test (CS-PFP) to people with Parkinson disease. Neurol Rep. 2002;26:130–138
  31. Hearty T, Schenkman M, Kohrt W, Cress ME. Continuous Scale Physical Functional Performance Test: appropriateness for middle aged adults with and without Parkinson's disease. J Neurol Phys Ther. 2007;31:64–70
  32. Kingsley JD, Panton LB, Toole T, Sirithienthad P, Mathis R, McMillan V. The effects of a 12-week strength-training program on strength and functionality in women with fibromyalgia. Arch Phys Med Rehab. 2005;86(9):1713–1721
  33. Hearty T, Demmon K, Jordan S, Schenkman M. Physical functional performance: a matched comparison between individuals with and without low back pain. Presented at the Combined Sections Meeting of the American Physical Therapy Association, February 2003, Tampa, Florida.
  34. Airaksinen O, Brox JI, Cedrashi C, Hildebrandt J, Klaber-Moffet J, Kovacs F, et al. COST B13 Working Group on Guidelines for Chronic Low Back Pain European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15:s192–s300
  35. Cottingham JT, Maitland J. A three-paradigm treatment model using soft tissue mobilization and guided movement-awareness techniques for a patient with chronic low back pain: a case study. J Orthop Sports Phys Ther. 1997;26:155–167
  36. Stevans J, Hall KG. Motor skill acquisition strategies for rehabilitation of low back pain. J Orthop Sports Phys Ther. 1998;28:165–167
  37. Edwards I, Jones MA, Hillier S. The interpretation of experience and its relationship to body movement: a clinical reasoning perspective. Man Ther. 2006;11:2–10
  38. Von Korff M, Balderson B, Saunders K, Miglioretti DL, Lin EH, Berry S, et al. A trial of an activating intervention for chronic back pain in primary care and physical therapy settings. Pain. 2005;113:323–330
  39. Haig AJ, Geisser ME, Michel B, et al. The Spine Team Assessment for chronic back pain disability (Part 2: team decision and a preliminary outcome study). Disab Rehab. 2006;28:1079–1086
  40. Goldby LF, Moore AP, Doust J, Trew ME. A randomized controlled trial investigation the efficiency of musculoskeletal physiotherapy on chronic low back disorder. Spine. 2006;31:1083–1093
  41. Moffett JK, Torgerson D, Bell-Syer S, et al. Randomized controlled trial of exercise for low back pain: clinical outcomes, costs, and preferences. BMJ. 1999;319:279–283
  42. Von Korff M, Moore J, Lorig K, et al. A randomized trial of a lay person-led self-management group intervention for back pain patients in primary care. Spine. 1998;23:2608–2615
  43. Strong LL, Von Korff M, Saunders K, Moore JE. Cost-effectiveness of two self-care interventions to reduce disability associated with back pain. Spine. 2006;15:1639–1645
  44. Woodard CM, Berry MJ. Enhancing adherence to prescribed exercise: structured behavioral interventions in clinical exercise programs. J Cardiopulm Rehabil. 2001;21:201–209
  45. Jensen GM, Lorish CD. Promoting patient cooperation with exercise programs (Linking research, theory, and practice). Arthritis Care Res. 1994;7:181–189
  46. Stelzner D, Rodriguez J, Krapfl B, Jordan S, Schenkman M. Instructor's Adherence Protocol (Instructor's Guidelines for Assisting Participants). Denver, CO: Physical Therapy Program, University of Colorado Denver; 2003;

 This work was supported by funding from The Foundation for Physical Therapy.

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org]

PII: S1934-1482(08)00015-4

doi: 10.1016/j.pmrj.2008.10.004

PM&R
Volume 1, Issue 2 , Pages 137-146 , February 2009

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