Chronic low back pain (CLBP) poses a significant challenge for patients and healthcare providers alike, often necessitating exercise therapy for management. However, determining the most effective treatment approach and understanding which patients may not respond optimally remains a complex issue.

In 2007, a study led by Tom Petersen, alongside Kristian Larsen and Soren Jacobsen, a randomized controlled trial was conducted to compare the long-term effectiveness of McKenzie treatment versus strengthening training for individuals with CLBP. The research aimed to not only evaluate treatment outcomes but also to identify patient-related factors associated with poor prognosis fourteen months post-treatment completion.

The trial included 260 participants with chronic low back pain. Various outcome measures such as functional status, pain levels, work status, and healthcare service utilization during follow-up were assessed. Additionally, factors contributing to withdrawal during the intervention were investigated.

The results revealed no significant differences in outcomes between the McKenzie therapy and strengthening training groups at the 14-month follow-up mark. However, several patient-related factors were identified as potential indicators of poor long-term outcomes. These included low levels of pain intensity and disability, sick leave at the onset of the study, low expectations regarding future work ability prior to treatment, withdrawal during the treatment period, and discontinuation of exercises after the conclusion of the treatment regimen.

The findings underscore the complexity of managing CLBP and suggest that patient-specific factors may play a crucial role in determining treatment success. Importantly, these prognostic factors were found to be more influential in predicting outcomes than the specific exercise programs utilized in the study.

This research contributes valuable insights into the personalized management of chronic low back pain, highlighting the importance of considering individual patient characteristics when designing treatment plans. By identifying factors associated with poor outcomes, healthcare professionals can better tailor interventions to meet the diverse needs of patients with CLBP, ultimately improving long-term treatment efficacy and patient satisfaction.

Reference: Petersen, T., Larsen, K., & Jacobsen, S. (2007). One-year follow-up comparison of the effectiveness of McKenzie treatment and strengthening training for patients with chronic low back pain: outcome and prognostic factors.