Study Summary

Sixty-four adolescent athletes with active lumbar spondylolysis were randomized to receive immediate physical therapy or rest before physical therapy. The primary outcome of interest was pain and disability measured by the Micheli Functional Scale. Secondary outcomes included time to return to sport, recurrence of low back pain, magnetic resonance imaging (MRI) healing, and patient-reported measures (depression, fear of movement, quality of life). Outcomes were assessed at baseline, 1 month (primary endpoint), 3 months, and 12 months. Overall, the results of the study revealed that the immediate physical therapy group demonstrated significantly greater improvements in pain and disability at 1 month, returned to sport earlier, and had fewer recurrences of low back pain compared with the rest before therapy group. These findings suggest that early initiation of physical therapy may be more effective than delaying treatment in this population.