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Physiological Work Performance in Chronic Low Back Disability: Effects of a Progressive Activity Program

Mrs. Thomas was a graduate student, Physical Therapy Department, University of Southern California, Rancho Los Amigos Center, 12933 Erickson Ave, Downey, CA 90242, when the study was conducted. She is currently a Research Physical Therapist, Pathokinesiology Service, Rancho Los Amigos Hospital, Downey, CA 90242.
Dr. Hislop is Professor and Chairman, Physical Therapy Department, University of Southern California.
Dr. Waters is Assistant Director of the Pathokinesiology Service and Chief of Surgical Services, Rancho Los Amigos Hospital.

Fifteen patients were tested before and after treatment in a multifaceted inpatient program for chronic low back pain to determine if a gradually progressive activity program affected gait performance and physiological capacity. Before treatment, all patients demonstrated decreased physiological conditioning by higher-than-expected values for oxygen consumption and heart rate and by lower-than-normal gait velocity, stride length, and cadence.

After treatment, an increase in mean walking velocity of 19 meters/minute reflected parallel gains in cadence and stride length. Improved mechanical performance resulted in improved "energetics." Energy spent per unit of distance walked decreased by 18 percent after treatment, providing a useful measure of increased physiological efficiency.

Results indicated that patients with chronic low back disability can derive significant conditioning effects from an exercise program based on general function.

Key Words: Energy metabolism • Exercise therapy • Lumbosacral region • Pain, intractable • Physical fitness • Physical therapy