Early physical therapy versus standard care for patients with low back pain .
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Early Physical Therapy vs Usual Care in Patients With Recent-Onset Low Back Pain: A Randomized Clinical Trial
JAMA. 2015 Oct 13;314(14):1459-67220 patients with low back pain for less than 16 days were randomly assigned to receive either early physical therapy (EPT) or usual care for the management of their low back pain. The purpose of this study was to determine whether early physical therapy consisting of exercise and manipulation was advantageous over usual care in improving disability, measured via Oswestry Disability Index (ODI) scores. Significantly greater improvement in ODI disability scores among patients treated with EPT was observed at 3 months compared to those treated with only usual care, though failed to reach the defined minimum clinically important difference. Patients in the EPT group also demonstrated improvements in EQ-5D overall health scores, Pain Catastrophizing Scores and fear-avoidance beliefs for work when compared to those in the usual care group, while showing no significant improvements in pain severity, fear-avoidance beliefs for physical activity or health care utilization.
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