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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Randomised controlled trial of physiotherapy compared with advice for low back pain
Authors: Frost, Helen
Lamb, Sarah E
Doll, Helen A
Taffe, Carver Patricia
Stewart-Brown, Sarah
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Issue Date: 23-Sep-2004
Publisher: BMJ Publishing Group
Citation: Frost H, Lamb SE, Doll HA, Taffe Carver P & Stewart-Brown S (2004) Randomised controlled trial of physiotherapy compared with advice for low back pain, BMJ, 329 (7468), pp. 708-711.
Abstract: Objective To measure the effectiveness of routine physiotherapy compared with an assessment session and advice from a physiotherapist for patients with low back pain.  Design Pragmatic, multicentre, randomised controlled trial.  Setting Seven British NHS physiotherapy departments.  Participants 286 patients with low back pain of more than six weeks' duration.  Intervention Routine physiotherapy or advice on remaining active from a physiotherapist. Both groups received an advice book.  Main outcome measures Primary outcome was scores on the Oswestry disability index at 12 months. Secondary outcomes were scores on the Oswestry disability index (two and six months), scores on the Roland and Morris disability questionnaire and SF-36 (2, 6 and 12 months), and patient perceived benefit from treatment (2, 6, and 12 months).  Results 200 of 286 patients (70%) provided follow up information at 12 months. Patients in the therapy group reported enhanced perceptions of benefit, but there was no evidence of a long term effect of physiotherapy in either disease specific or generic outcome measures (mean difference in change in Oswestry disability index scores at 12 months −1.0%, 95% confidence interval −3.7% to 1.6%). The most common treatments were low velocity spinal joint mobilisation techniques (72%, 104 of 144 patients) and lumbar spine mobility and abdominal strengthening exercises (94%, 136 patients).  Conclusions Routine physiotherapy seemed to be no more effective than one session of assessment and advice from a physiotherapist.
Type: Journal Article
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Rights: Publisher is open-access. Open access publishing allows free access to and distribution of published articles where the author retains copyright of their work by employing a Creative Commons attribution licence. Proper attribution of authorship and correct citation details should be given. Published in BMJ 2004;329:708
Affiliation: NMAHP Research
University of Warwick
University of Oxford
Nuffield Orthopaedic Centre
University of Warwick

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