Improved physical performance outcomes after functional restoration treatment in patients with chronic low-back pain. Early versus recent training results.

Abstract

Functional restoration, a medically supervised team treatment approach that addresses deficits that accompany the deconditioning process in patients with chronic low-back pain, has emerged as a viable rehabilitation alternative. While the primary emphasis of this treatment approach has remained unchanged since its inception over 6 years ago, recent rapid advances in quantification technology and understanding of the complexity of the chronic low-back pain (CLBP) syndrome have led to more sophisticated and aggressive rehabilitation efforts. In the current study, the authors examined two groups of patients with CLBP, from the treatment program's initial (n = 45) and most recent years (n = 57) of operation, respectively, to determine if the evolution of the treatment program has resulted in increased gains in physical capacity between these groups of patients. Patients in each group were assessed on measures of isokinetic trunk strength and spinal range of motion at program admission and discharge. Both groups demonstrated improved physical capacity levels, but the recent group also demonstrated considerably higher physical capacity levels than the early group, at both program admission and discharge. It was concluded that functional restoration continues to be successful with CLBP patients, and that increased preprogram training and education may facilitate a more rapid elimination of inhibitory factors (ie, pain, fear of reinjury), which often impede and slow physical training.