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Exercise Prescription for Patients With Persistent Low Back Pain Who Present With Impaired Lateral Abdominal Muscle
Caitlin Lauren Siobhan Prentice1, Carol Ann Flavell2, Nicola Massy-Westropp1
1Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
Summary
Physiotherapists should prescribe exercise for low back pain (LBP) by considering patient preferences and balancing motor control exercises with physical activity. This Delphi study offers expert consensus on exercise parameters for lateral abdominal muscle (LAM) activation in LBP patients.
Area of Science:
- Physiotherapy
- Rehabilitation Medicine
- Motor Control
Background:
- Low back pain (LBP) often involves maladaptive lateral abdominal muscle (LAM) activation.
- Current exercise prescriptions for LBP lack consistent evidence on optimal parameters.
- There is a need to define specific exercise guidelines for LBP patients with altered LAM activation.
Purpose of the Study:
- To determine optimal exercise prescription strategies for physiotherapists treating persistent LBP with maladaptive LAM activation.
- To establish expert consensus on exercise parameters for LBP rehabilitation.
- To guide clinical practice in prescribing exercise for LBP patients with specific muscle activation deficits.
Main Methods:
- A three-round Delphi survey was conducted with international physiotherapy experts.
- Expert panel comprised clinicians with postgraduate orthopaedic manipulative physiotherapy training.
- Consensus was defined as agreement from ≥70% of participants on exercise prescription items.
Main Results:
- Twenty-three physiotherapists participated, with high completion rates across Delphi rounds.
- Consensus was reached on 46 exercise prescription items.
- Key domains included exercise goals, considerations, LAM activation, and exercise focus.
Conclusions:
- Clinically informed recommendations for exercise prescription in LBP with maladaptive LAM activation were established.
- Findings support motor control exercise approaches for LBP.
- Emphasis was placed on patient preferences and integrating motor control with moderate-to-vigorous activity.
