PEDroCast Podcast

This season we are diving into ⁠PEDro's Top Trials⁠.

In this episode we are looking at Frost H et al., ⁠Randomised controlled trial for evaluation of fitness programme for patients with chronic low back pain. BMJ 1995;310(6973):151-4. ⁠Video here⁠.

Anne Moseley talked to Dr Helen Frost (Scottish Collaboration for Public Health Research and Policy, UK) whose trial evaluating fitness training for chronic low back pain is one of the 15 most significant trials in physiotherapy.

Anne: Could you explain what you did in the study?

Helen: The study evaluated a fitness program, designed to encourage people with chronic low back pain to become more physically active. People with chronic low back pain were randomised to 2 groups – both groups attended a back education program (back school) and were advised to exercise at home. In addition, one group also attended a progressive fitness program, twice a week for 4 weeks.

Anne: What was the main finding?
Helen: People who attended the fitness program reported less pain and disability than those that were advised to exercise on their own at home, at 6 months and 2 years after the intervention. They were able to walk further and faster and reported more confidence in their ability to carry out normal activities of daily living.

Anne: Why do you think your study is important?
Helen: At the time this study was carried out people with back pain were generally being treated very conservatively, sometimes even with bed rest but mostly on a one-to-one basis with passive treatment. So the fitness program aimed to give people confidence to exercise and take a more active approach to their back pain. Whilst it wasn't a new idea, as exercise has always been the root of the physiotherapy profession, in a hospital setting it was one of the first programs to be evaluated in a randomised controlled trial. It was a small single-centre study that led to other bigger multi-centre trials of physiotherapy intervention.

Anne: What lead you to do the study?
Helen: Research supported the need to change the approach to managing back pain and there was evidence to suggest that back pain should be treated more actively, yet most people with back pain didn't know where to start and were often afraid to exercise. The back fitness program was developed as a ”stepping stone” to help people overcome their fear of exercise. As it was a new service developed in a hospital setting, it was important to evaluate it.

Anne: What studies are you conducting now?
Helen: I am not carrying out any studies at the moment but I am very interested in developing research ideas aimed at encouraging older people to be more physically active and less sedentary.

Anne: Helen, thank you for making such a valuable contribution to physiotherapy.