Efficacy Of Behavioural Graded Activity Compared With Conventional Exercise Therapy In Chronic Non Specific Low Back Pain: Implication For Direct Health Care Cost

Abstract

Background: The relative efficacy of conventional exercise therapy (CET) and behavioural graded activity (BGA) has not been fully established to inform the preference in clinical practice. Objective: To compare CET and BGA on the treat ment outcome of chronic non-specific low back pain (LBP). Methodology: Participants were assigned into either BGA or CET group in this randomized feasibility in tervention. The CET group received supervised exer cise therapy while BGA group engaged in individually prescribed sub-maximal activities based on time contingent principles. Interventions were carried out twice weekly and over a period of 12 weeks. Outcome measures were numerical rating scale and RAND 36 item health survey which were administered at base line, week 4 and week 12. Health care cost question naire was also administered to evaluate physiotherapy cost after 12 weeks. Mixed design two-way ANOVA with level of significance set as priori at p<0.05 was used to compare both groups. Results: Seventy-seven and half percent (62) partici pants (CET=29 and BGA=33) with mean ages 45.0±12.2 and 43.1±13.2years respectively, completed the study. Both groups improved significantly (p<0.001) during the intervention. However, there were no significant differences (p>0.05) between the treat ment groups at any time points and for any measures assessed. Therapeutic benefits in both groups have bearing on direct health care costs. Conclusion: The results indicate that CET and BGA have similar outcomes in patients with chronic nonspe cific LBP with regard to the pain and quality of life. Effective application may however be hampered by the cost-related factors thus suggesting evaluation of health care system in Ghana.