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Motor control exercises, sling exercises, and general exercises for patients with chronic low back pain: a randomized
Monica Unsgaard-Tøndel1, Anne Margrethe Fladmark, Øyvind Salvesen
1Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. monica.unsgaard.tondel@ntnu.no
Background:
Exercise benefits patients with chronic nonspecific low back pain; however, the most effective type of exercise remains unknown.
Objective:
This study compared outcomes after motor control exercises, sling exercises, and general exercises for low back pain.
Design:
This was a randomized controlled trial with a 1-year follow-up.
Setting:
The study was conducted in a primary care setting in Norway.
Patients:
The participants were patients with chronic nonspecific low back pain (n=109).
Interventions:
The interventions in this study were low-load motor control exercises, high-load sling exercises, or general exercises, all delivered by experienced physical therapists, once a week for 8 weeks.
Measurements:
The primary outcome measure was pain reported on the Numeric Pain Rating Scale after treatment and at a 1-year follow-up. Secondary outcome measures were self-reported activity limitation (assessed with the Oswestry Disability Index), clinically examined function (assessed with the Fingertip-to-Floor Test), and fear-avoidance beliefs after intervention.
Results:
The postintervention assessment showed no significant differences among groups with respect to pain (overall group difference) or any of the outcome measures. Mean (95% confidence interval) group differences for pain reduction after treatment and after 1 year were 0.3 (-0.7 to 1.3) and 0.4 (-0.7 to 1.4) for motor control exercises versus sling exercises, 0.7 (-0.6 to 2.0) and 0.3 (-0.8 to 1.4) for sling exercises versus general exercises, and 1.0 (-0.1 to 2.0) and 0.7 (-0.3 to 1.7) for motor control exercises versus general exercises.
Limitations:
The nature of the interventions made blinding impossible.
Conclusions:
This study gave no evidence that 8 treatments with individually instructed motor control exercises or sling exercises were superior to general exercises for chronic low back pain.
