The short-term effects of graded activity versus physiotherapy in patients with chronic low back pain: A randomized controlled trial

Magalhães, Mauricio Oliveira; Muzi, Luzilauri Harumi; Comachio, Josielli; Burke, Thomaz Nogueira; Renovato França, Fabio Jorge; Vidal Ramos, Luiz Armando; Leão Almeida, Gabriel Peixoto; de Moura Campos Carvalho-e-Silva, Ana Paula; Marques, Amélia Pasqual

doi:10.1016/j.math.2015.02.004

Cited by 50Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyPregnancy-related medical research

The short-term effects of graded activity versus physiotherapy in patients with chronic low back pain: A randomized controlled trial

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Magalhães, Mauricio Oliveira, Muzi, Luzilauri Harumi, Comachio, Josielli, Burke, Thomaz Nogueira, Renovato França, Fabio Jorge, Vidal Ramos, Luiz Armando, Leão Almeida, Gabriel Peixoto, de Moura Campos Carvalho-e-Silva, Ana Paula +1 more·2015·Manual Therapy

DOI 10.1016/j.math.2015.02.004

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Abstract

Background Chronic low back pain is one of the most common problematic health conditions worldwide and is highly associated with disability, quality of life, emotional changes, and work absenteeism. Graded activity programs, based on cognitive behavioral therapy, and exercises are common treatments for patients with low back pain. However, recent evidence has shown that there is no evidence to support graded activity for patients with chronic nonspecific low back pain.Aim to compare the effectiveness of graded activity and physiotherapy in patients with chronic nonspecific low back pain.Methods A total of 66 patients with chronic nonspecific low back pain were randomized to perform either graded activity (moderate intensity treadmill walking, brief education and strength exercises) or physiotherapy (strengthening, stretching and motor control). These patients received individual sessions twice a week for six weeks. The primary measures were intensity of pain (Pain Numerical Rating Scale) and disability (Rolland Morris Disability Questionnaire).Results After six weeks, significant improvements have been observed in all outcome measures of both groups, with a non-significant difference between the groups. For intensity of pain (mean difference = 0.1 points, 95% confidence interval [CI] = -1.1-1.3) and disability (mean difference = 0.8 points, 95% confidence interval [CI] = -2.6-4.2). No differences were found in the remaining outcomes.Conclusion The results of this study suggest that graded activity and physiotherapy showed to be effective and have similar effects for patients with chronic nonspecific low back pain.

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Physiotherapy has a beneficial effect on pain intensity and physical function for musculoskeletal pain.
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UNDERSTANDING AND EVALUATING THE ROLE OF GRADED ACTIVITY IN THE MANAGEMENT OF CHRONIC NON-SPECIFIC LOW BACK PAIN
Almeida de Oliveira, L. (2025) · MacSphere (McMaster University) · doi:10.71548/7905

Authors: Magalhães, M. O., Muzi, L. H., Comachio, J., Burke, T. N., Renovato França, F. J., Vidal Ramos, L. A., Leão Almeida, G. P., de Moura Campos Carvalho-e-Silva, A. P., & Marques, A. P.
Affiliations: Universidade de São Paulo (BR)
ORCID: Comachio, Josielli
Burke, Thomaz Nogueira
Marques, Amélia Pasqual
Venue: Manual Therapy
Publisher: Elsevier BV
Published: 2015-08
Volume: 20
Issue: 4
Pages: 603-609
ISSN: 1356-689X (ISSN-L)
DOI: 10.1016/j.math.2015.02.004
OpenAlex: W2003441451
Cited by: 50
References: 52
Citations by year: 2026: 2 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 8 · 2020: 6 · 2019: 5 · 2018: 4 · 2017: 4 · 2016: 7
FWCI: 3.60
Type: journal article
Language: en
Open access: green
www.sciencedirect.com
Licence: other-oa
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Manual Therapy (publishedVersion)
PubMed (publishedVersion)
LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
Funders: Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP), Brazil (2012/18182-5)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
Keywords: chronic non-specific low back pain, graded activity, physiotherapy, treadmill walking, resistance training, stretching, motor control, pain intensity, disability, cognitive behavioral therapy
MeSH terms: Adult, Exercise Therapy, Female, Health Education, Health Status, Humans, Male, Middle Aged, Pain Measurement, Quality of Life, Exercise, Low Back Pain, Behavior Control

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The short-term effects of graded activity versus physiotherapy in patients with chronic low back pain: A randomized controlled trial

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