Motor Control Exercise for Chronic Low Back Pain: A Randomized Placebo-Controlled Trial-Reference-Cited by-同舟云学术

Motor Control Exercise for Chronic Low Back Pain: A Randomized Placebo-Controlled Trial

Published:2009-12-01 Issue:12 Volume:89 Page:1275-1286
ISSN:0031-9023
Container-title:Physical Therapy
language:en
Short-container-title:

Author:

Costa Leonardo O.P.¹,Maher Christopher G.²,Latimer Jane³,Hodges Paul W.⁴,Herbert Robert D.⁵,Refshauge Kathryn M.⁶,McAuley James H.⁷,Jennings Matthew D.⁸

Affiliation:

1. L.O.P. Costa, PT, PhD, is Research Fellow, Musculoskeletal Division, The George Institute for International Health, PO Box M201, Missenden Rd, Sydney, New South Wales 2050, Australia.

2. C.G. Maher, PT, PhD, is Director, Musculoskeletal Division, The George Institute for International Health, and Professor, Sydney Medical School, The University of Sydney, Sydney, Australia.

3. J. Latimer, PT, PhD, is Senior Research Fellow, Musculoskeletal Division, The George Institute for International Health, and Associate Professor, Sydney Medical School, The University of Sydney.

4. P.W. Hodges, PhD, Bphty(Hons), is Professor and NHMRC Principal Research Fellow/Professorial Research Fellow, Division of Physiotherapy, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.

5. R.D. Herbert, PT, PhD, is Senior Research Fellow, Musculoskeletal Division, The George Institute for International Health, and Associate Professor, Sydney Medical School, The University of Sydney.

6. K.M. Refshauge, DipPhty, GradDipManipTher, MBiomedE, PhD, is Director, Research & Innovation, and Deputy Dean, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.

7. J.H. McAuley, PhD, is Research Manager, Musculoskeletal Division, The George Institute for International Health.

8. M.D. Jennings, PT (Hons), is Deputy Director, Physiotherapy Department, Liverpool Hospital, Sydney South West and Western Sydney Area Health Services, Sydney, Australia.

Abstract

BackgroundThe evidence that exercise intervention is effective for treatment of chronic low back pain comes from trials that are not placebo-controlled.ObjectiveThe purpose of this study was to investigate the efficacy of motor control exercise for people with chronic low back pain.DesignThis was a randomized, placebo-controlled trial.SettingThe study was conducted in an outpatient physical therapy department in Australia.PatientsThe participants were 154 patients with chronic low back pain of more than 12 weeks’ duration.InterventionTwelve sessions of motor control exercise (ie, exercises designed to improve function of specific muscles of the low back region and the control of posture and movement) or placebo (ie, detuned ultrasound therapy and detuned short-wave therapy) were conducted over 8 weeks.MeasurementsPrimary outcomes were pain intensity, activity (measured by the Patient-Specific Functional Scale), and patient's global impression of recovery measured at 2 months. Secondary outcomes were pain; activity (measured by the Patient-Specific Functional Scale); patient's global impression of recovery measured at 6 and 12 months; activity limitation (measured by the Roland-Morris Disability Questionnaire) at 2, 6, and 12 months; and risk of persistent or recurrent pain at 12 months.ResultsThe exercise intervention improved activity and patient's global impression of recovery but did not clearly reduce pain at 2 months. The mean effect of exercise on activity (measured by the Patient-Specific Functional Scale) was 1.1 points (95% confidence interval [CI]=0.3 to 1.8), the mean effect on global impression of recovery was 1.5 points (95% CI=0.4 to 2.5), and the mean effect on pain was 0.9 points (95% CI=−0.01 to 1.8), all measured on 11-point scales. Secondary outcomes also favored motor control exercise.LimitationClinicians could not be blinded to the intervention they provided.ConclusionsMotor control exercise produced short-term improvements in global impression of recovery and activity, but not pain, for people with chronic low back pain. Most of the effects observed in the short term were maintained at the 6- and 12-month follow-ups.

Publisher

Oxford University Press (OUP)

Subject

Physical Therapy, Sports Therapy and Rehabilitation

Link

http://academic.oup.com/ptj/article-pdf/89/12/1275/31663483/ptj1275.pdf

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