In 1993, A. Delitto, et. al., conducted a recent study, the prescriptive validity of a treatment-oriented extension-mobilization category for patients with acute low back syndrome (LBS) was thoroughly investigated. The primary goal was to assess the effectiveness of this approach in the conservative management of selected patients with LBS.

A total of 39 patients with LBS referred for physical therapy participated in the study. Among them, 24 patients (14 male, 10 female), aged 14 to 50 years, exhibited signs and symptoms that indicated the suitability of an extension-mobilization approach. The remaining subjects were excluded from the study. The patients falling into the extension-mobilization category were randomly assigned to either the experimental (treatment) group (n = 14) or the comparison group (n = 10).

The experimental and comparison group subjects underwent either mobilization and extension (a treatment matched to the category) or a flexion exercise regimen (an unmatched treatment). The modified Oswestry Low Back Pain Questionnaire was administered initially and at 3 and 5 days after the initiation of treatment to assess outcomes. The data were analyzed using a 2 x 3 (treatment group x treatment period) analysis of variance.

The analysis revealed that the rate of improvement, as indicated by the Oswestry questionnaire scores, was significantly dependent on the treatment group to which the patients were assigned. Subjects treated with extension and mobilization exhibited a notably faster positive response compared to those subjected to a flexion-oriented program.

This study provides valuable insights into the conservative management of acute low back syndrome by illustrating the efficacy of a priori classification of selected patients into a treatment category of extension and mobilization. The positive outcomes observed in subjects treated according to this specified intervention highlight the potential effectiveness of this approach. The findings suggest that tailoring treatments based on a predetermined category may be a promising avenue for enhancing the outcomes of conservative management in selected patients with acute low back syndrome.

Reference: Delitto, A., Cibulka, M. T., Erhard, R. E., Bowling, R. W., & Tenhula, J. A. (1993). Evidence for use of an extension-mobilization category in acute low back syndrome: a prescriptive validation pilot study. Physical Therapy, 73(4), 216-222.