A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: Short-term results of a randomised controlled trial

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• 作者：Jeannette Saner ; MSc ; PT^a ; ^b ; ^{jeannette.saner@zhaw.ch" class="auth_mail" title="E-mail the corresponding author} ; ; Judith M. Sieben ; PhD^b ; ^c ; Jan Kool ; PhD ; PT^a ; Hannu Luomajoki ; PhD ; PT^a ; Carolien H.G. Bastiaenen ; PhD ; PT^b ; ^d ; Rob A. de Bie ; PhD ; PT^b ; ^d
• 关键词：Randomised controlled trial ; Movement control impairment ; Exercise ; Low back pain ; Clinical trial ; Posture ; Rehabilitation ; Patient specific functional scale
• 刊名：Journal of Bodywork and Movement Therapies
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：20
• 期：1
• 页码：189-202
• 全文大小：3161 K

文摘

Exercise is an effective treatment for patients with sub-acute and chronic low back pain (LBP). Patients with a movement control impairment (MCI) can be diagnosed as a subgroup of patients with LBP. Unknown is which exercise intervention is most beneficial for this subgroup.

This study assessed the short-term effect of a specific exercise program targeting movement control impairment versus general exercise treatment on disability in patients with LBP and MCI.

Methods

In a multicentre parallel group randomised controlled pragmatic trial, patients with sub-acute and chronic LBP were included. Further inclusion criteria were disability of ≥5 points on the Roland–Morris Disability Questionnaire and ≥2 positive tests out of a set of 6 movement control impairment tests.

A total of 106 patients were randomly assigned to either tailored movement control exercise intervention (MC, n = 52) or a general exercise intervention (GE, n = 54); both 9–18 individual treatment sessions, over a maximum of 12 weeks. The primary outcome was disability measured with the Patient Specific Functional scale (PSFS). Secondary outcome was the Roland–Morris disability scale (RMDQ). Measurements were taken pre- and posttreatment.

Results

No significant difference was found following the treatment period. Baseline-adjusted between-group mean difference for the PSFS was 0.5 (SD = 0.5; p = 0.32) in favour of MC exercises. The Roland–Morris Disability Questionnaire revealed a significant, but not clinically relevant, between-group difference of 2.0 points (SD = 0.8; p = 0.01).

Conclusion

Disability in LBP patients was reduced considerably by both interventions. However, the limited contrast between the two exercise programs may have influenced outcomes.