Document Detail


Unloaded movement facilitation exercise compared to no exercise or alternative therapy on outcomes for people with nonspecific chronic low back pain: a systematic review.
MedLine Citation:
PMID:  17509439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to determine the effect of unloaded movement facilitation exercises on outcomes for people with nonspecific chronic low back pain (NSCLBP). METHODS: This systematic review was conducted according to Cochrane Back Review Group and Quality of Reporting of Meta-analyses (QUORUM) guidelines. Exercise effects were reported as standardized mean difference (SMD) with 95% confidence intervals (95% CI). RESULTS: Six high-quality randomized controlled trials were included. For NSCLBP effects favored McKenzie therapy over intensive trunk strengthening for pain: SMD: short-term: 0.35 (0.10, 0.59); long-term 0.36 (0.12, 0.61) and short-term function: SMD: 0.45 (0.20, 0.70) and were comparable for medium-term function: SMD: 0.15 (-0.90, 0.40). Effects of favored McKenzie therapy were comparable to specific spinal stabilization exercises for short-term pain: SMD: 0.63 (-0.11, 1.38) and function: SMD: 0.47 (-0.27, 1.20). Pooled effects favored McKenzie therapy over other exercises for short-term pain (pooled SMD: 0.38 (0.14, 0.61)) and were comparable for short-term function: SMD: 0.10 (-0.20, 0.40). Yoga compared to trunk strengthening produced comparable effects for pain: (SMD: short-term: 0.13 (-0.46, 0.71); medium-term 0.51 (-0.08, 1.11)) and function SMD: short-term: 0.51 (-0.08, 1.10); medium-term 0.38 (-0.22, 0.97)). Compared to education, effects of yoga were large for medium-term pain and function (pooled SMDs: 0.92 (0.47, 1.37); 0.95 (0.50, 1.40)). Effects favored unloaded movement facilitation exercises of McKenzie compared to other or no exercise and were comparable for yoga. CONCLUSIONS: For NSCLBP, there is strong evidence that unloaded movement facilitation exercise, compared to no exercise, improves pain and function. Compared to other types of exercise, including effort-intensive strengthening and time-intensive stabilization exercise, the effects are comparable. This challenges the role of strengthening for NSCLBP.
Authors:
Susan C Slade; Jennifer L Keating
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  Journal of manipulative and physiological therapeutics     Volume:  30     ISSN:  1532-6586     ISO Abbreviation:  J Manipulative Physiol Ther     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-18     Completed Date:  2007-07-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7807107     Medline TA:  J Manipulative Physiol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  301-11     Citation Subset:  IM    
Affiliation:
School of Primary Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia. elgarphysio@bigpond.com <elgarphysio@bigpond.com>
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MeSH Terms
Descriptor/Qualifier:
Exercise Therapy / methods*
Humans
Low Back Pain / physiopathology,  therapy*
Lumbar Vertebrae / physiopathology
Movement
Outcome and Process Assessment (Health Care)
Patient Education as Topic
Rest
Self Care
Treatment Outcome
Yoga

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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