Benefits of a physical training program after back school for chronic low back pain patients

Objectives: Compare a treatment combining a back school program and physical training with a treatment consisting of only aback school program undertaken by chronic low back pain [CLBP] patients. Methods: Forty CLBP patients [21 females] completed an educational back school program. Once ended, 17 subjects [the Education-Physical Group [EPG]] started physical training sessions attended twice a week [90 minutes] for six weeks. The others constituted the Education Group [EG]. All subjects performed three tests: the pain visual analog scale, the Dallas questionnaire assessing quality of life, and an ergonomic test at the beginning [Day [D] 1], at the end [D21] of the back school program, and three months later [D120]. The EPG also carried out physical tests at the start and at the end of the physical training. Results: At D21, no significant difference in pain and Dallas scores appeared, although patients of both groups performed the ergonomic test significantly better. At D120, the decrease of pain intensity and the quality of life improvement were significant in both groups [P < 0.05]. The extent of the pain intensity decrease was significantly higher in the EPG compared to the EG. The EPG displayed improvements in most physical assessments [P < 0.05]. Only the increase of knee extensors strength correlated significantly with the improvements of quality of life and ergonomic function scores. Conclusions: This study supports positive effects of a back school program for CLBP patients. Additional physical training sessions lead to lower pain intensity, greater improvement of quality of life than back school sessions only, as well as improvement of muscle performances. The increase of the knee extensors strength might have helped to decrease the pain and improve the quality of life.