The effect of dynamic strength back exercise and/or a home training program in 57-year-old women with chronic low back pain - Results of a prospective randomized study with a 3-year follow-up period

Study design. A prospective, randomized investigation. Objectives. To compare the effect of dynamic strength back muscle training with that of a home training program and to evaluate the long-term effect of the home training program in patients with chronic low back pain. Summary of Background Data. In a health survey of 57-year-old women, those with chronic low back pain were selected using the Nordic Questionnaire. Of 172 women with low back pain, 74 participated in the study. Methods. The participants were randomly assigned to either dynamic strength back exercises at a fitness center and a home training program or to the home training program for the first 3 months, after which both groups continued to pursue the home training program. Follow-up observation was by examination at 3 and 12 months and by mailed questionnaire after 3 years. The primary effect variables were disability, sick-leave, and use of health care services. Results. Both training groups manifested significant improvement at the 3- and 12-month follow-up examinations, yet the adherence rate was much better in the group assigned to the fitness center. Those who adhered to the training program for the first year manifested significant improvement according to the 3-year follow-up questionnaire. There was a significant reduction in the number of women on sick-leave and in use of health care services after 1 year, but not after 3 years. Conclusions. The home training program was as effective as the supervised dynamic strength muscle training program and yielded lasting improvement after at least 1 year of adherence. The adherence rate was much better, however, when the training was supervised at the start.