Exercise based intervention for chronic low back pain, correlates of treatment success and patient characteristics

Abstract

Chronic low back pain (CLBP) is a major cause of disability worldwide, affecting a substantial proportion of the population and imposing significant physical and economic burdens. Physiotherapy is widely recommended, but evidence on its clinical effectiveness in Bangladesh is limited. This study aimed to evaluate the effectiveness of exercise-based physiotherapy interventions on pain reduction and lumbar mobility in patients with CLBP and to identify correlates of treatment success. A descriptive study was conducted at a rehabilitation center in Dhaka, Bangladesh, from June to December 2022. Medical records of 400 patients with non-specific CLBP were reviewed. Data on demographics, pain intensity, lumbar mobility, physiotherapy interventions, treatment sessions, and self-reported improvement were extracted. Pain was assessed using the Visual Analogue Scale (VAS), and lumbar mobility was measured by flexion and extension. Correlation and multiple regression analyses were conducted to identify predictors of pain reduction. Among 400 patients, 61.3% were female, and the most common age group was 21-30 years (45.8%). Mean baseline VAS was 6.7±1.6, which decreased significantly to 3.1±1.5 post-treatment (p<0.001). Substantial improvements in lumbar flexion and extension were observed (all p<0.001). Over half of patients (52.3%) reported ≥76% improvement in pain. Correlation analysis indicated that the number of treatment sessions (r=0.21, p<0.001) and therapeutic exercise (r=0.15-0.18, p<0.001) were significantly associated with clinical improvement. Multiple regression analysis identified treatment sessions (β=0.19, p<0.001) and therapeutic exercise (β=0.15, p=0.003) as significant predictors of pain reduction. Gender-based analysis showed higher baseline pain in females (p<0.001), but post-treatment improvement was significant in both sexes. Exercise-based physiotherapy, particularly when delivered through sufficient treatment sessions, is highly effective in reducing pain and improving lumbar mobility in Bangladeshi patients with CLBP. Structured therapeutic exercises and adherence to treatment sessions are key factors influencing clinical outcomes.