EFFECT OF EXERCISE ON SICK LEAVE DUE TO LOW-BACK-PAIN - A RANDOMIZED,COMPARATIVE, LONG-TERM STUDY

Study Design. The study was carried out as an open, randomized, multic enter, parallel-group study with an observation period of 12 months. F our Norwegian physiotherapy institutes took part. Patients were subseq uently followed for 12 months of home exercise on their own, without t he supervision of a physiotherapist. Objectives. 1) To investigate and compare the effects of two different exercise programs on low back pr oblems in patients after a 1-year training program under the supervisi on of a physiotherapist. 2) To investigate the effect supervision by, and motivation from, physiotherapists has on training compliance and e fficacy. Summary of Background Data. After ordinary physiotherapy trea tment for low back problems, patients were randomly allocated either t o a conventional training program designed by physiotherapists or to a training program using a new Norwegian-developed training apparatus c alled the TerapiMaster. The study included 153 patients with low back problems, all of whom had been referred to physiotherapy by their gene ral practitioners. One hundred twenty-six patients were followed for a n additional 12 months when performing home exercise programs on their own. Methods. Monitoring patient satisfaction with the training progr am, compliance with the program, and absenteeism from work during the training period. Results. Patient satisfaction with both training prog rams was high, with about 83% of participating patients completing the study in accordance with the protocol. Mean absenteeism (SD) during t he preceding year totaled 82.5 days (19.8) in the conventional trainin g group and 61.6 days (14.7) in the TerapiMaster group. Significant re ductions to 17.2 days (6.0) and 15.4 days (5.3) in the two groups, res pectively, were recorded during the training period, corresponding to a 75% to 80% reduction compared with the preceding 1-year period. Mean absenteeism showed a further significant decline during the 12-month period without supervised training. The average values were 9.9 days ( 3.2) for conventional training and 9.3 days (3.1) for the TerapiMaster , respectively. Conclusions. Both exercise programs reduced absenteeis m significantly (75-80%). No difference in the effects of the two diff erent programs was discernible. Regular follow-up through encouragemen t and variation in the training programs appear to be important factor s for motivating patients to adhere to regular exercise programs for l ow back problems. This thesis was corroborated by 12-month study of un supervised exercise.