{
  "abstract": "Objectives To compare the effects of initiating physical therapy (PT) immediately versus resting before starting PT on pain and dysfunction over 12 months in adolescent athletes (10–19 years) with active lumbar spondylolysis.Methods This prospective multicentre trial randomised participants to immediate PT or rest before PT. The immediate PT group began PT within 7 days and progressed based on pain and function. The rest before PT group started PT once symptoms resolved and progressed based on time. The primary outcome was pain and disability (Micheli Functional Scale) between groups over time, measured at baseline, 1 (primary end point), 3 and 12 months. Time to return to sport and the recurrence rate of low back pain (LBP) were also assessed. Outcomes were analysed using an intention-to-treat approach.Results Sixty-four participants (median age 14.2 years; 40% female) were randomised to immediate PT (n=30) and rest before PT (n=34). At 1 month, the immediate PT group showed significant improvements in pain and disability (mean difference on Micheli Functional Scale of 21.3, 95% CI 28.7 to 13.9; p<0.001). They also returned to sport 38 days sooner (p<0.001), with fewer recurrences of LBP over 12 months (3% vs 29%; p=0.01). There were no adverse events.Conclusions Clinicians may consider prescribing PT immediately after diagnosing active lumbar spondylolysis instead of rest. Immediate PT showed greater initial improvements in pain and dysfunction, a quicker return to sport and a lower recurrence of LBP compared with rest before PT among adolescent athletes with spondylolysis.Trial registration number NCT05505981.",
  "authors": [
    {
      "affiliations": [
        "Sports and Orthopedic Physical Therapy, Nationwide Children’s Hospital, Columbus, Ohio, USA"
      ],
      "name": "Mitchell Selhorst"
    },
    {
      "affiliations": [
        "Sports Medicine Center, Children’s Hospital Colorado, Aurora, Colorado, USA",
        "University of Colorado School of Medicine, Aurora, Colorado, USA"
      ],
      "name": "Emily Sweeney"
    },
    {
      "affiliations": [
        "Department of Radiology, Nationwide Children’s Hospital, Columbus, Ohio, USA"
      ],
      "name": "Lisa C Martin"
    },
    {
      "affiliations": [
        "Center for Injury Research and Policy, Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, USA",
        "The Ohio State University, College of Medicine, Columbus, Ohio, USA"
      ],
      "name": "Jingzhen Yang"
    },
    {
      "affiliations": [
        "Center for Biostatistics, The Ohio State University, Columbus, Ohio, USA"
      ],
      "name": "Jason Benedict"
    },
    {
      "affiliations": [
        "School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA"
      ],
      "name": "Madison Brna"
    },
    {
      "affiliations": [
        "Sports Medicine, Nationwide Children’s Hospital, Columbus, Ohio, USA",
        "Children’s Hospital Colorado, Aurora, Colorado, USA"
      ],
      "name": "Spondylolysis Physician Group"
    },
    {
      "affiliations": [
        "Sports Medicine and Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio, USA",
        "The Ohio State University, Columbus, Ohio, USA"
      ],
      "name": "Anastasia N Fischer"
    }
  ],
  "title": "Immediate physical therapy is beneficial for adolescent athletes with active lumbar spondylolysis: a multicentre randomised trial",
  "uid": "adab4249-f077-5ec7-9288-054b582c09a3"
}