A Systematic Review Of The Evidence For Motor Control Exercises In The Treatment Of Non-Specific Chronic Low Back Pain
(2013) A Systematic Review Of The Evidence For Motor Control Exercises In The Treatment Of Non-Specific Chronic Low Back Pain, no. 112.
1 1. Abstract 1.1 Objectives The primary objective of this study was to review randomised controlled trials (RCTs) investigating the efficacy of motor control exercises (MCE) in the management of non- specific chronic low back pain (NSCLBP), in terms of pain and function. In order to establish the effects of these exercises, body impairment was included as a secondary outcome. 1.2 Methods To locate relevant RCTs, six electronic databases were searched: CINAHL, MEDLINE, PEDro, PubMed, SCOPUS and SPORTDiscus using keywords advocated by a previous trial (Ferreira et al. 2006), and other keywords which were relevant and specific to the more focussed review than that done previously. 1.3 Inclusion/ exclusion criteria All articles had to be RCTs or randomised clinical trials published in the English language. All participants within potential trials had to suffer from NSCLBP. One of the interventions had to consist of only MCE, with the exception of cognitive behavioural therapy (CBT) as an adjunct, provided that comparator interventions also received CBT. Pain or function had to be an outcome measure and trials which included an outcome measuring body impairment were favoured. 1.4 Results Seven studies located through the electronic databases met the required criteria for inclusion within this review. Each of the studies showed beneficial effects following MCE interventions, with four significantly improving function, and three significantly improving pain. Additionally, the implementation of MCE appeared to have positive effects on activation of the deep, stabilising muscles of the trunk; enhancing spinal stability. Comparisons against other common treatments were inconclusive, with little significance noted between groups. 1.5 Conclusions The lack of studies investigating body impairment has meant that whilst MCE has produced beneficial effects for both pain and function, the reasoning behind these results is largely unfounded and is therefore based on theory. Future research should be aimed at investigating the morphological and neuromuscular adaptations following MCE in NSCLBP.