Sensorimotor Stabilization Exercises With and Without Behavioral Treatment in Low Back Pain: Feasibility and Effects...

Area of Science:

• Rehabilitation Medicine
• Exercise Science
• Clinical Biomechanics

Background:

• Nonspecific low back pain (LBP) is a prevalent condition with significant disability.
• Sensorimotor stabilization training (SMT) aims to improve motor control and reduce pain in LBP patients.
• The addition of behavioral therapy (BT) may enhance the effectiveness of SMT.

Purpose of the Study:

• To assess the feasibility and effects of a 12-week sensorimotor stabilization exercise intervention for nonspecific low back pain.
• To compare sensorimotor training (SMT) with and without behavioral therapy (SMT+BT) against a usual care group (UCG).

Main Methods:

• A three-armed, multicenter randomized controlled trial involving 662 participants with low back pain.
• Interventions included SMT, SMT+BT, and UCG. Training comprised 3 weeks center-based and 9 weeks home-based.
• Outcomes measured adherence, dropout rates, adverse events, pain intensity, disability, and trunk torque.

Main Results:

• High adherence (>80%) was observed for both SMT and SMT+BT, despite significant dropout rates (around 50% by week 12).
• SMT showed significant improvement in pain intensity (P=.011, d=0.41) compared to UCG.
• SMT+BT demonstrated significant improvements in disability (P=.020, d=0.41) and peak torque (P=.019, d=0.44) compared to UCG.

Conclusions:

• Sensorimotor stabilization exercise interventions are feasible for individuals with low back pain.
• While SMT improved pain and SMT+BT improved disability, both interventions led to neuromuscular adaptations and increased strength.
• High dropout rates, particularly during the home-based phase, highlight a challenge for long-term adherence.