Immediate Physical Therapy vs. Rest for Adolescent Lumbar Spondylolysis: A Pilot Randomized Controlled Trial (bjsm.bmj.com)

• RCT compares immediate PT (IFPP) vs rest for adolescent athletes (10-19 yrs) with spondylolysis.
• IFPP starts within 7 days, progresses through three phases: neutral spine, functional motion, return to sport.
• Control rests until pain resolves, then begins same PT with time-based progression.
• Primary outcomes: Micheli Functional Scale, MRI edema, PedsQL, time to return to sport.
• Secondary outcomes: lumbar multifidus CSA, depressive symptoms, fear-avoidance beliefs.
• Sponsor: Nationwide Children's Hospital; collaborator: Children's Hospital Colorado.

"This pilot RCT compares an Immediate Functional Progression Program (IFPP) to rest for adolescent athletes with acute spondylolysis. The IFPP group starts physical therapy within 7 days of diagnosis, progressing through three phases: neutral spine, functional motion, and return to sport, guided by pain and function. The control group rests until pain resolves (assessed every 4 weeks) then begins the same PT program. Primary outcomes include the Micheli Functional Scale, edema on MRI, quality of life (PedsQL), and time to return to sport. Secondary outcomes include lumbar multifidus changes, depressive symptoms, and fear-avoidance beliefs. The study is recruiting at Nationwide Children's Hospital and Children's Hospital Colorado."