The role of backbuilders exercise program in low back pain: Vijay Vad, MD (Hospital for Special Surgery-Cornell, New York, NY); Ronald Mackenzie, MD; Leon Root, MD.

Arch Phys Med Rehabil. 2003 Sep;84(9):E19-E20.

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OBJECTIVE: To evaluate the efficacy of the Back Builders exercise program on patients with diskogenic low back pain (LBP). Design: Prospective randomized trial. Setting: Outpatient clinical setting at a major university teaching hospital. Participants: Inclusion criteria were documented evidence of disk herniation (by magnetic resonance imaging) with at least 3 months symptoms of LBP and/or leg pain. The exclusion criterion was prior history of back surgery. Interventions: Patients were randomized into 2 groups. Group 1 (n=25) performed, for 15 minutes 3 times weekly, the Back Builders program designed by the principal author, who used the principles of medical yoga and Pilates to minimize disk pressures. In addition to the exercise program, patients took 200mg of celecoxib with hydrocodone and acetaminophen for breakthrough pain. Group 2 (n=25) underwent medication treatment with 200mg of celecoxib with hydrocodone and acetaminophen for breakthrough pain. Both groups were age and sex matched. Main Outcome Measures: Outcome measures included Roland-Morris Disability Questionnaire, numeric pain score, patient satisfaction, and distance from finger to floor (in centimeters). A successful outcome was defined as >50% pain reduction with good or better patient satisfaction. Results: At a minimum of 12 months of follow-up with an average follow-up of 12.3 months (range, 12-14mo), group 1 had 72% (18/25) successful outcomes and group 2 reported 36% (8/22, 3 lost to follow-up) successful outcomes (P=.001). In group 1, 16% (y/25) reported recurrence of acute symptoms versus 50% (11/22) in group 2 (P=.001). Conclusion: A well-designed program for patients with disk problems that minimizes disk pressures while restoring flexibility, strength, endurance, balance, and posture may yield superior results to oral medications with reduction in recurrence of back pain.

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