Document Detail


Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review.
MedLine Citation:
PMID:  22072093     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The effect size for exercise therapy in the treatment of chronic non-specific low back pain (cLBP) is only modest. This review aims to analyse the specificity of the effect by examining the relationship between the changes in clinical outcome (pain, disability) and the changes in the targeted aspects of physical function (muscle strength, mobility, muscular endurance) after exercise therapy.
METHODS: We searched for exercise therapy trials for cLBP published up to 15 April 2010 in Medline, Embase, Cochrane Library, Cinahl, and PEDro. Two independent reviewers selected studies according to the inclusion criteria. Data extraction: one author extracted the data of the articles.
RESULTS: Data synthesis: 16 studies with a total of 1,476 participants met the inclusion criteria. There was little evidence supporting a relationship between the changes in pain or physical function and the changes in performance for the following measures: mobility (no correlation in 9 studies, weak correlation in 1 study), trunk extension strength (7 and 2, respectively), trunk flexion strength (4 and 1, respectively) and back muscle endurance (7 and 0, respectively). Changes in disability showed no correlation with changes in mobility in three studies and a weak correlation in two; for strength, the numbers were four (no correlation) and two (weak correlation), respectively.
CONCLUSIONS: The findings do not support the notion that the treatment effects of exercise therapy in cLBP are directly attributable to changes in the musculoskeletal system. Future research aimed at increasing the effectiveness of exercise therapy in cLBP should explore the coincidental factors influencing symptom improvement.
Authors:
F Steiger; B Wirth; E D de Bruin; A F Mannion
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2011-11-10
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  21     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-24     Completed Date:  2012-10-24     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  575-98     Citation Subset:  IM    
Affiliation:
Institute of Human Movement Sciences and Sport, ETH Zürich, Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Disability Evaluation
Exercise Therapy*
Humans
Low Back Pain / physiopathology,  therapy*
Muscle Strength / physiology*
Musculoskeletal System / physiopathology
Physical Endurance / physiology*
Questionnaires
Treatment Outcome
Comments/Corrections
Comment In:
Eur Spine J. 2012 Sep;21(9):1887; author reply 1888-9   [PMID:  22832874 ]

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


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