Primary studies included in this systematic review

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The effects of sensorimotor training on anticipatory postural adjustment of the trunk in chronic low back pain patients.

Authors Hwang JA , Bae SH , Do Kim G , Kim KY
Journal Journal of physical therapy science
Year 2013
Links Pubmed DOI PubMed Central

This article is included in 1 Systematic review Systematic reviews (1 reference)

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[Purpose] This study aimed to examine the effects of sensorimotor training on the anticipatory postural adjustment (APA) of chronic low back pain (CLBP) patients. [Subjects and Methods] Fourteen CLBP patients were randomly assigned to Group II (ordinary physical therapy, n=7) and Group III (sensorimotor training, n=7). In addition, a normal group (Group I) consisting of seven subjects was chosen as the control group. The two CLBP groups received their own treatment five times per week, for four weeks, for 40 minutes each time. Changes in pain and functional performance evaluation were examined by the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). In order to look at the change in APA, muscle onset time was examined using electromyography (EMG). [Results] Group III showed significant changes in both VAS and ODI. According to comparison of the results for muscle onset time, there were significant decreases in Group III's transversus abdominis muscle (TrA) and external oblique muscle (EO) in the standing and sitting positions. There were significant differences between Group II and III in terms of the TrA in the sitting position. [Conclusion] Sensorimotor training makes patients capable of learning how to adjust muscles, thereby alleviating pain and improving muscle performance.

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Effects of stabilization exercise using a ball on mutifidus cross-sectional area in patients with chronic low back pain.

Authors Chung S , Lee J , Yoon J
Journal Journal of sports science & medicine
Year 2013
Links Pubmed

This article is included in 1 Systematic review Systematic reviews (1 reference)

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The purpose of this study was to compare the effects of lumbar stabilization exercises using balls to the effects of general lumbar stabilization exercises with respect to changes in the cross section of the multifidus (MF), weight bearing, pain, and functional disorders in patients with non-specific chronic low back pain. Twelve patients participated in either a 8 week (3 days per week) stabilization exercise program using balls and control group (n = 12). The computer tomography (CT) was used to analyze MF cross-sectional areas (CSA) and Tetrax balancing scale was used to analyze left and right weight bearing differences. Both groups had significant changes in the CSA of the MF by segment after training (p < 0.05) and the experimental group showed greater increases at the L4 (F = 9.854, p = 0.005) and L5 (F = 39. 266, p = 0.000). Both groups showed significant decreases in weight bearing, from 9.25% to 5.83% in the experimental group and from 9.33% to 4.25% in the control group (p < 0.05), but did not differ significantly between the two groups. These results suggests that stabilization exercises using ball can increases in the CSA of the MF segments, improvement in weight bearing, pain relief, and recovery from functional disorders, and the increases in the CSA of the MF of the L4 and L5 segments for patients with low back pain. Key PointsCompared with the stabilization exercise using a ball and general stabilization exercise increased the CSA of the MF, weight bearing, pain, and functional ability in patients with low back pain.We verified that increases in the CSA of the MF of the L4 and L5 segments and functional ability during the stabilization exercise using a ball.The stabilization exercise using a ball was shown to be an effective exercise method for patients with low back pain in a rehabilitation program by increasing functional ability and the CSA of the MF.

Primary study

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The effect of balance training on cervical sensorimotor function and neck pain.

Authors Beinert K , Taube W
Journal Journal of motor behavior
Year 2013
Links Pubmed DOI

This article is included in 1 Systematic review Systematic reviews (1 reference)

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The authors' aim was to evaluate the effect of balance training on cervical joint position sense in people with subclinical neck pain. Thirty-four participants were randomly assigned to balance training or to stay active. Sensorimotor function was determined before and after 5 weeks of training by assessing the ability to reproduce the neutral head position and a predefined rotated head position. After balance training, the intervention group showed improved joint repositioning accuracy and decreased pain whereas no effects were observed in the control group. A weak correlation was identified between reduced neck pain intensity and improved joint repositioning. The present data demonstrate that balance training can effectively improve cervical sensorimotor function and decrease neck pain intensity.

Primary study

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Efficacy of perceptive rehabilitation in the treatment of chronic nonspecific low back pain through a new tool: A randomized clinical study.

Journal Clinical rehabilitation
Year 2012
Links Pubmed DOI

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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OBJECTIVE: To evaluate the efficacy of a perceptive rehabilitative approach, based on a new device, with regard to pain and disability in patients with chronic nonspecific low back pain. DESIGN: Single blind, randomized, controlled trial. SETTING: An outpatient academic hospital. PATIENTS: Seventy-five patients with chronic low back pain. INTERVENTIONS: Patients were randomized into three groups. Twenty-five subjects received 10 sessions in one month, based on specific perceptive exercises that were performed on a suitably developed device. Twenty-five patients entered a Back School programme. Twenty-five patients comprised a control group that received the same medical and pharmacological assistance as the other groups. Main outcome measures: Pain was assessed using the Visual Analogue Scale and McGill Pain Questionnaire. Disability was evaluated using the Oswestry Disability Index and Waddell Disability Index. All measurements were recorded before treatment, at the end of the study, and at 12 and 24 weeks. RESULTS: General pain relief was recorded in all the groups, which was elicited more quickly in the perceptive treatment group; significant differences in pain scores were observed at the end of treatment (<i>P</i> &lt; 0.001 for visual analogue scale and <i>P</i> = 0.001 for Questionnaire) versus the other groups. Disability scores in the perceptive group did not differ significantly from those in the other group, whereas these scores significantly differed between Back School and control groups at the follow-ups (<i>P</i> &lt; 0.01 for both scales). CONCLUSION: Perceptive rehabilitation has immediate positive effects on pain. Back School reduces disabilities at follow-up. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Primary study

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The efficacy of a perceptive rehabilitation on postural control in patients with chronic nonspecific low back pain.

Journal International journal of rehabilitation research. Internationale Zeitschrift für Rehabilitationsforschung. Revue internationale de recherches de réadaptation
Year 2012
Links Pubmed DOI

This article is included in 1 Systematic review Systematic reviews (1 reference)

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Patients with chronic low back pain have a worse posture, probably related to poor control of the back muscles and altered perception of the trunk midline. The aim of this study was to evaluate the efficacy of a perceptive rehabilitation in terms of stability and pain relief in patients with chronic nonspecific low back pain. Thirty patients were enrolled and randomized into two groups: 15 patients received rehabilitation, on the basis of a specific tool to perform perceptive exercises [perceptive group (PG)], and 15 patients received a back school programme [back school group (BG)]. Both groups were assessed using stabilometry and the McGill Pain Questionnaire before and at the end of treatment. For the reference values of stabilometric parameters, 15 healthy individuals were enrolled. Significant reductions in sway length (P=0.019) and laterolateral sway velocity (P=0.038) were observed in the PG. The anteroposterior sway velocity was reduced in both the groups, but significantly only for BG (P=0.048). The percentage of sway length reduction was inversely and significantly correlated with the initial sway length value for PG (R=-0.708, P=0.003), but not for BG (R=-0.321, P=0.243). In the PG, the sagittal arrows and bi-acromial and bi-spinoiliac lines' angles were all significantly reduced. General pain relief was reported after treatment, without a significant difference (P=0.436). Our results suggest that a perceptive rehabilitation can improve the postural stability for the realignment of the trunk, controlling the back pain. The use of cognitive exercises may strengthen the usual rehabilitation of low back pain, avoiding the recurrence of symptoms.

Primary study

Unclassified

Lumbar stabilization exercises in addition to strengthening and stretching exercises reduce pain and increase function in patients with chronic low back pain

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Journal Turkish Journal of Physical Medicine and Rehabilitation
Year 2012
Links DOI ftrdergisi.com Google Scholar

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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OBJECTIVE: Lumbar stabilization exercises aim to activate and strengthen deep abdominal and back muscles. Exercise program, presented in this study, combines activation of specific lumbar stabilizing muscles with traditional strengthening and stretching exercises. The main goal of this study was to establish the effect of stabilization exercises on pain reduction and funcionality in patients with chronic low back pain (CLBP). MATERIALS AND METHODS: Prospective randomized clinical study was conducted in the Clinical Center Nis, from January 2007 until March 2009. 160 patients with CLBP were eligible and met the inclusion criteria. The study group (S; n=100) had specific lumbar stabilization exercises, while the patients in the control group (C; n=60) performed traditional program for CLBP, based on the strengthening and stretching of the large, superficial back muscles. For monitoring patients, Oswestry Disability Score (ODS) and Short-form 36 (SF- 36), were used. RESULTS: After the therapy, pain was successfully reduced in both groups with higher statistical significance in the study group: p<0.001. Improvement of ODS was statistically more significant in study group compared to the control group (p<0.001). CONCLUSION: Stabilization exercises proved to be a significant addition to the traditional programs, regarding pain reduction and functional improvement in CLBP patients.

Primary study

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Efficacy of trunk balance exercises for individuals with chronic low back pain: a randomized clinical trial.

Journal The Journal of orthopaedic and sports physical therapy
Year 2011
Links Pubmed DOI

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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STUDY DESIGN: Randomized clinical trial. OBJECTIVES: To determine the efficacy of trunk balance exercises for individuals with chronic low back pain. BACKGROUND: The majority of exercises focusing on restoring lumbopelvic stability propose targeting the feedforward control of the lumbopelvic region. Less attention has been paid to feedback control during balance adjustments. METHODS: Seventy-nine patients were randomly allocated to 2 different groups. The experimental group performed trunk balance exercises in addition to standard trunk flexibility exercises. The control group performed strengthening exercises in addition to the same standard trunk flexibility exercises. The primary outcome measures were pain intensity (visual analogue scale), disability (Roland-Morris Questionnaire), and quality of life (12-Item Short-Form Health Survey). Secondary outcomes were painful positions, use of analgesic drugs, and referred pain. Analysis of variance and relative risk were used to analyze the data for the primary and secondary outcome measures, respectively. The number of participants reaching the minimal clinically important difference in the 2 groups for each outcome measure was compared using relative risk. RESULTS: A significant difference in scores on the Roland-Morris Questionnaire (P = .011) and the physical component of the 12-Item Short-Form Health Survey (P = .048), and in the number of participants reaching the minimal clinically important difference for the Roland-Morris Questionnaire (relative risk, 1.79; 95% confidence interval [CI]: 1.05, 3.04) and the secondary outcome of painful positions (relative risk, 1.37; 95% CI: 1.03, 1.83) were found in favor of the experimental treatment. CONCLUSIONS: Trunk balance exercises combined with flexibility exercises were found to be more effective than a combination of strength and flexibility exercises in reducing disability and improving the physical component of quality of life in patients with chronic low back pain.

Primary study

Unclassified

Multimodal group rehabilitation compared to usual care for patients with chronic neck pain: A pilot study

Authors Hudson JS , Ryan CG
Journal Manual therapy
Year 2010
Links Pubmed DOI

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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The aim of this pilot randomised controlled trial (RCT) was to compare multimodal group rehabilitation to usual care physiotherapy for patients with chronic neck pain (CNP). Participants (n= 14) were randomly assigned to one of two interventions, multimodal group rehabilitation or usual care physiotherapy. Multimodal group rehabilitation involved stability, strengthening and proprioceptive exercises along with an educational programme. Patients attended for 1 h, once a week for six weeks. The usual care group was treated as deemed appropriate by their physiotherapist. A blinded assessor recorded baseline and post-intervention scores of disability and pain using the neck disability index (NDI) and the 0-10 pain numerical rating scale (NRS), respectively. One participant from each group dropped out before receiving any intervention. Post-intervention both groups significantly improved in both function and pain scores (p≤ 0.01). The mean change in the NDI scores for the multimodal group versus the usual care group were 12.3 ± 5.3% and 7.4 ± 4.8%, and pain NRS score changes were 4.6 ± 2.3 and 4.5 ± 2.2, respectively. There was no significant difference in improvements in disability (p= 0.84) or pain (p= 0.67) between groups. These results warrant further investigation of multimodal group rehabilitation for CNP, and provide data to inform an appropriately powered full-scale RCT with long-term follow-up. © 2010 Elsevier Ltd.

Primary study

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An educational approach based on a non-injury model compared with individual symptom-based physical training in chronic LBP. A pragmatic, randomised trial with a one-year follow-up.

Journal BMC musculoskeletal disorders
Year 2010
Links Pubmed DOI PubMed Central

This article is included in 1 Systematic review Systematic reviews (1 reference)

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<b>BACKGROUND: </b>In the treatment of chronic back pain, cognitive methods are attracting increased attention due to evidence of effectiveness similar to that of traditional therapies. The purpose of this study was to compare the effectiveness of performing a cognitive intervention based on a non-injury model with that of a symptom-based physical training method on the outcomes of low back pain (LBP), activity limitation, LBP attitudes (fear-avoidance beliefs and back beliefs), physical activity levels, sick leave, and quality of life, in chronic LBP patients.<b>METHODS: </b>The study was a pragmatic, single-blind, randomised, parallel-group trial. Patients with chronic/recurrent LBP were randomised to one of the following treatments: 1. Educational programme : the emphasis was on creating confidence that the back is strong, that loads normally do not cause any damage despite occasional temporary pain, that reducing the focus on the pain might facilitate more natural and less painful movements, and that it is beneficial to stay physically active. 2. Individual symptom-based physical training programme : directional-preference exercises for those centralising their pain with repetitive movements; 'stabilising exercises' for those deemed 'unstable' based on specific tests; or intensive dynamic exercises for the remaining patients. Follow-up questionnaires (examiner-blinded) were completed at 2, 6 and 12 months. The main statistical test was an ANCOVA adjusted for baseline values.<b>RESULTS: </b>A total of 207 patients participated with the median age of 39 years (IQR 33-47); 52% were female, 105 were randomised to the educational programme and 102 to the physical training programme. The two groups were comparable at baseline. For the primary outcome measures, there was a non-significant trend towards activity limitation being reduced mostly in the educational programme group, although of doubtful clinical relevance. Regarding secondary outcomes, improvement in fear-avoidance beliefs was also better in the educational programme group. All other variables were about equally influenced by the two treatments. The median number of treatment sessions was 3 for the educational programme group and 6 for the physical training programme group.<b>CONCLUSIONS: </b>An educational approach to treatment for chronic LBP resulted in at least as good outcomes as a symptom-based physical training method, despite fewer treatment sessions.

Primary study

Unclassified

Efficacy and treatment compliance of a home-based rehabilitation programme for chronic low back pain: A randomized, controlled study

Journal Annals of physical and rehabilitation medicine
Year 2009
Links Pubmed DOI

This article is included in 1 Systematic review Systematic reviews (1 reference)

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Objective: To assess the efficacy and treatment compliance of a home-based rehabilitation programme for chronic low back pain (CLBP). Population: CLBP outpatients treated in a Physical Medicine Rehabilitation or Rheumatology unit within a university hospital. Methods: We performed a prospective, comparative study. The participants were randomly assigned to either a home-based rehabilitation programme (Gp A) or a standard physical therapy (Gp B). The programme included four weekly sessions. In each group, we measured pain intensity (on a visual analogue scale, VAS), flexibility and muscle endurance (the Schöber MacRae test, finger-to-floor distance, thigh-leg angle, the Shirado and Sorensen test), functional and psychological repercussions (the Quebec functional index and the Hospital Anxiety and Depression scale) and handicap (on a VAS). Follow-up examinations took place at baseline and four weeks and three, six and 12 months later. Results: One hundred and seven patients (82 women) with a mean ± standard deviation (S.D.) age of 35.7 ± 0.8 years were included (with 54 patients in Gp A). At four weeks, a significant improvement (relative to baseline) was observed for all parameters in both study groups but with a significantly greater difference in Gp A, which was maintained at one year (despite an observed regression of the improvement at six months). At one year, compliance with the home-based rehabilitation programme was good (68.1%) and 59.5% of the patients regarded the programme as useful. Conclusion: Our results suggest that a home-based rehabilitation programme is as effective as standard physical therapy. However, this type of programme requires patient motivation and regular follow-up. © 2009 Elsevier Masson SAS. All rights reserved.