Comparison of group motor control training versus individual training for people suffering from back pain

This study investigated the effects of "motor-control training" (MCT) using the model of deficits in the activation of transversus abdominis (TrA) in people with recurrent back pain. The purpose of this investigation was to establish whether MCT - implemented within a new group intervention (experimental group) - is able to produce results similar to those of a conventional intervention applied individually (control group) to people suffering from back pain. Using the form of an experimental pre-post-test design, the study consisted of an experimental group (N = 18, mean age M = 45.2; SD = 18.4; 9 ♂, 9 ♀) and a comparison group (N = 13; age = 56.6; SD = 18.5; 6 ♂, 7 ♀). The training covered a period of six weeks, with two training sessions per week. The amount of training was the same in both groups. Aside from the same extent of training, the participants in the experimental group completed training content in the group interventions identical to that completed by the comparison group in the individual treatments. To clarify: The difference between the two groups was that the participants in the individual-therapy control group received individual feedback on their exercise performance and correction notes from the instructor. This degree of individual attention was not given within the group therapy. The selective activation of the M. transversus abdominis (TrA) was the main focus of the intervention, with the intent of improving its stabilising corset function, especially within the lumbar region, via increased tension of the thoracolumbar fascia. To record the progress of both groups, the anterolateral abdominal muscle recruitment of the M. transversus abdominis (TrA) was measured as a main influencing factor for anterolateral stabilisation of the spine. For measurements of muscle recruitment, rehabilitative ultrasound imaging (M-Turbo™ SonoSite(®) Erlangen in B-Mode) according to Whittaker (2007) was used. Furthermore, the relationship between pain relief and the development of muscle recruitment was evaluated. Finally, the possible pain relief and the improvement of daily routine disruptions were assessed via the visual analogous scale (VAS) and the Oswestry Disability Questionnaire (ODI) (Mannion et al., 2006a,b). Both forms of intervention produced significant improvements in abdominal muscle control and pain (p < 0.003; p < 0.007). However, according to Cohen (1988), the effect sizes could be classified as a low to medium effect advantage on the part of the individual treatment (d < 0.5). Nevertheless, there were no statistically significant differences between individual and group interventions for the measured parameters, indicating that the group interventions can be considered more efficient because more patients were helped at the same time with similar effort. This result provides new and valuable insights for doctors, sports medicine specialists and physiotherapists, as well as for the sponsors of prescribed treatments, and it confirms the usefulness of integrating the new form of intervention into existing multimodal back therapy training concepts.