Alaranta 1994.

Methods	RCT; 2 arms;assessed at pretreatment, 3 months follow‐up, 1 year follow‐up
Participants	3 month follow‐up n = 286 Start of treatment n = 293 Sex: 160 F, 133 M Mean age = 40.5 (SD 4.5) Source = patients referred for inpatient rehabilitation Diagnosis = chronic low back pain Mean years of pain = not given (minimum 6 months)
Interventions	"progressive intervention of intensive physical training and psychosocial activation AKSELI" "control: less intensive physical training and passive physical therapies"
Outcomes	Primary pain outcome: none Primary disability outcome: none Primary mood outcome: BDI Catastrophising outcome: none 1. lumbar flexion‐extension 2. lateral flexion 3. trunk rotation 4. hamstring tightness 5. number of sit‐ups 6. number of arch‐ups 7. static strength of back muscles 8. number of squats 9. Million index of pain and disability mean of 14 items rated 0 to 100 10. low back pain capacity 1 to 3 11. leisure activities physical intensity 0 to 10 12. number of visits to doctors (12‐month follow‐up) 13. number of physical therapy outpatient visits (12‐month follow‐up) 14. WHO occupational handicap 0 to 5 15. sick days 16. Beck Depression Inventory 17. Symptom Check List 18. Multidimensional Health Locus of Control 19. Social Adjustment Scale 20. Karolinska Scales of Personality
Notes	Excluded from 2009 review for marginal psychological content; included in 2012 update No data Yates quality scale: total quality = 16/35, design quality = 13/26, treatment quality = 3/9
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	“patients stratified according to age … and sex and randomly divided into intervention and control groups”
Allocation concealment (selection bias)	High risk	No information but post‐randomisation exclusion of patients “not fit” for intervention group
Incomplete outcome data (attrition bias) All outcomes	High risk	Attrition implied not reported; no reporting of differences
Selective reporting (reporting bias)	High risk	Many outcomes not reported
Blinding of outcome assessment (detection bias) All outcomes	High risk	Self report and examination by physiatrist and physiotherapist at baseline and follow‐up. No statement about blinding.