Relationship Between Patient-oriented Outcomes Over A 6-week Exercise Program For Non-specific Low Back Pain

People who experience non-specific low back pain (NSLBP) are impacted personally, socially, and economically. It is necessary to provide individuals rehabilitation exercises that are feasible and can positively influence patient-oriented outcomes, such as disability and global rating of change (GROC). The GROC is a quick, quantitative measure that can be implemented by practitioners to calculate a magnitude of change (i.e., worse, the same, or better). However, it is unclear how disability and GROC relate to one another throughout two delivery methods of 6 weeks of at-home core exercise. PURPOSE: To measure the association between disability and GROC scores at baseline, after 3 weeks and 6 weeks of at-home rehabilitation. METHODS: Forty participants (17 male, 23 female, age = 23.8 ± 5.6 years, height = 168.4 ± 8.6 cm, weight = 72.3 ± 14.4 kg) with self-reported NSLBP were randomized into the intervention or control group. Thirty participants completed the 6-week program, which included the same core exercises completed until failure for both groups. The intervention group (n = 17) received the program through exercise videos and weekly exercise leaderboards. The control group (n = 13) was given a printed, take home exercise packet. The Oswestry Disability Index (ODI) was distributed at baseline, 3 weeks, and 6 weeks. The GROC scale was completed after 6 weeks. Spearman’s rho correlations were calculated between the ODI and GROC. Alpha was set a priori at p < .05 and an intention-to-treat analysis was conducted for missing data. RESULTS: Control group ODI scores were 15.93 ± 11.64 at baseline, 15.35 ± 14.17 after 3 weeks, 11.29 ± 9.8 after 6 weeks, and GROC was 4.7 ± 1.34. There was a strong, negative correlation between ODI at baseline and GROC (ρ = -.657, p = .002), and ODI at 3-weeks and GROC (ρ = -.667, p = .001). A very strong correlation was observed at 6 weeks (ρ = -.871, p < .001). Intervention group ODI scores were 13.91 ± 7.16 at baseline, 9.81 ± 7.16 after 3 weeks, 8.00 ± 5.91 after 6 weeks, and GROC was 5.34 ± 1.12. There was a weak, non-significant relationship between ODI and GROC in the intervention group at all time points (p > .05). CONCLUSIONS: GROC scores were associated with disability at 3 weeks and 6 weeks for the take-home exercise packet group. As objective disability measures decreased, subjective patient improvement increased.