The Effects of Supplementary Exercise Therapy on the Functional Disability and Pain in Subjects with Acute Nonspecific Low Back Pain: A Randomized Single-Blind Clinical Trial

Introduction: There is controversy for prescribing active exercise therapy in subjects suffering from nonspecific low back pains in acute phase. The aim of this study was comparing the effects of standard rehabilitation protocol with and without exercise therapy in acute nonspecific low back pain. Materials and Methods: 43 volunteers with acute nonspecific low back pain were randomly assigned into experimental (spinal manipulation plus active exercise, n = 21) and control (spinal manipulation, n = 22) groups. After signing formal consent, demographic information was obtained. Immediate analgesic effect was reported measuring pain intensity using visual analog scale (VAS) before and immediately after the manipulation in either group. Pain intensity and disability score according to Oswestry Disability Index were reported at the beginning, after the 10th therapeutic session, and at one-month follow-up. Results: 40 subjects completed the study. Pain and functional disability score decreased significantly over time in both groups (P < 0.001), although intergroup differences were not significant for pain severity (P = 0.24) and functional disability score (P = 0.42). In addition, the pain after a session of manipulation was significantly lower than before treatment (P < 0.001). Conclusion: It seems that in spite of immediate significant improvement in pain and functional disability following supplementary exercise therapy protocol, it is not significantly different from manipulation. More studies are recommended to investigate the effect of various exercise protocols in different types of low back pain.