The Effect of Exercise Programs on Pain Management and Motor Control in Patients with Nonspecific Chronic Low Back Pain: A Randomized Matched Subjects Trial

Fatemeh Fazel, Vahid Zolaktaf, Shahram Lenjan Nezhadian

Abstract


Backgroud: Many exercise approaches have been suggested for the treatment of nonspecific chronic low back pain. However, the best exercise approach is still unknown. The purpose of this study was to compare the effect of three exercise approaches based on the Postural Restoration Institute (PRI) and National Academy of Sports Medicine (NASM) on the pain management and motor control of men with nonspecific chronic low back pain. Methods: The study was designed with matched subjects. Thirty‑three participants were randomly assigned to three training groups: NASM (n = 11), PRI (n = 11), and NASM‑PRI integration (n = 11). Interventions: The participants in each group performed the exercise for eight weeks, three sessions per week and about one hour each session. Pain was measured using a visual analog scale (VAS) scale and functional disability using the Roland–Morris questionnaire. Also, the movement control impairment was measured by the movement control impairment test set. Results: Repeated measures ANOVA showed no significant interaction effect between pain perception, functional disability, and movement control impairment of the groups (P >.05). Conclusions: The findings suggest that different types of exercise rehabilitation were not significantly different on pain reduction, functional disability, and movement control impairment. It is suggested that the participant’s preference for an approach should also be considered for encouraging them to adhere to exercise.

Keywords


Exercise; low back pain; movement control

Full Text:

PDF

References


Paolucci T, Attanasi C, Cecchini W, Marazzi A, Capobianco SV,

Santilli V. Chronic low back pain and postural rehabilitation

exercise: A literature review. J Pain Res 2019;12:95‑107.

Johnson CD, Haldeman S, Chou R, Nordin M, Green BN,

Côté P, et al. The Global Spine Care Initiative: Model of care

and implementation. Eur Spine J 2018;27:925‑45.

Woolf AD. Controlling the burden of spinal disorders in low‑and

middle‑income countries. Eur Spine J 2018;27:773‑5.

Mutubuki EN, Luitjens MA, Maas ET, Huygen FJ, Ostelo RW,

van Tulder MW, et al. Predictive factors of high societal

costs among chronic low back pain patients. Eur J Pain

;24:325‑37.

de Aquino Nava GT, Tozim BM, Morcelli MH, Naveg MT. The

trunk muscles behavior in women with low back pain in the test

of flexion and extension of the trunk. MTP Rehab J 2020;1‑6.

doi: 10.17784/mtprehabjournal.2017.15.493.

White CA. The Effect of PRI Pelvic Repositioning Technique on

Innominate Rotation and Hip Range of Motion. The University

of North Carolina at Chapel Hill; 2018.

Roshini PD, Aseer L, Antony P. Motor control training in chronic

low back pain. J Clin Diagn Res 2019;13:YC01‑5.

Hutting N, Johnston V, Staal JB, Heerkens YF. Promoting the

use of self‑management strategies for people with persistent

musculoskeletal disorders: The role of physical therapists.

J Orthop Sports Phys Ther 2019;49:212‑5.

Roland M, Morris R. A study of the natural history of low‑back

pain. Part II: Development of guidelines for trials of treatment in

primary care. Spine 1983;8:145‑50.

Luomajoki H, Kool J, De Bruin ED, Airaksinen O. Reliability of

movement control tests in the lumbar spine. BMC Musculoskelet

Disord 2007;8:90.

Centre for Effective Practice, Government of Ontario. Clinically

Organized Relevant Exam (CORE) Back Tool [Internet]. 2016.

Available from: https://cep.health/media/uploaded/CEP_CORE_

Back_2016.pdf. [Last accessed on 2020 Jul 25].

Clark M, Lucett S. NASM Essentials of Corrective Exercise

Training. Lippincott Williams & Wilkins; 2010.

Spence H. Case study report: Postural restoration: An effective

physical therapy approach to patient treatment. Tech Reg Anesth

Pain Manag 2008;12:102‑4.

Costa LOP, Maher CG, Latimer J, Ferreira PH,

Pozzi GC, Ribeiro RN. Psychometric characteristics of

the Brazilian‑Portuguese versions of the functional rating

index and the Roland Morris disability questionnaire.

Spine 2007;32:1902‑7.

Miyamoto GC, Franco KFM, van Dongen JM,

dos Santos Franco YR, de Oliveira NTB, Amaral DDV, et al.

Different doses of Pilates‑based exercise therapy for chronic

low back pain: A randomised controlled trial with economic

evaluation. Br J Sports Med 2018;52:859‑68.

Lin HT, Hung WC, Hung JL, Wu PS, Liaw LJ,

Chang JH. Effects of pilates on patients with chronic

non‑specific low back pain: A systematic review. J Phys Ther

Sci 2016;28:2961‑9.

Shiri R, Coggon D, Falah‑Hassani K. Exercise for the prevention

of low back pain: Systematic review and meta‑analysis of

controlled trials. Am J Epidemiol 2017;187:1093‑101.

Patti A, Bianco A, Paoli A, Messina G, Montalto MA,

Bellafiore M, et al. Effects of Pilates exercise programs in

people with chronic low back pain: A systematic review.

Medicine (Baltimore) 2015;94:e383.

Patti A, Bianco A, Paoli A, Messina G, Montalto MA,

Bellafiore M, et al. Pain perception and stabilometric parameters

in people with chronic low back pain after a Pilates exercise

program: A randomized controlled trial. Medicine (Baltimore)

;95:e2414.

Saragiotto BT, Maher CG, Yamato TP, Costa LO, Costa LCM,

Ostelo RW, et al. Motor control exercise for nonspecific low

back pain: A Cochrane Review. Spine 2016;41:1284‑95.

Gomes‑Neto M, Lopes JM, Conceicao CS, Araujo A,

Brasileiro A, Sousa C, et al. Stabilization exercise compared to

general exercises or manual therapy for the management of low

back pain: A systematic review and meta‑analysis. Phys Ther

Sport 2017;23:136‑42.

Saner J, Kool J, Sieben JM, Luomajoki H, Bastiaenen CH,

de Bie RA. A tailored exercise program versus general exercise

for a subgroup of patients with low back pain and movement

control impairment: A randomised controlled trial with one‑year

follow‑up. Man Ther 2015;20:672‑9.

Luomajoki H, Kool J, de Bruin ED, Airaksinen O. Improvement

in low back movement control, decreased pain and disability,

resulting from specific exercise intervention. BMC Sports Sci

Med Rehabil 2010;2:11.

Gutknecht M, Mannig A, Waldvogel A, Wand BM, Luomajoki H.

The effect of motor control and tactile acuity training on

patients with non‑specific low back pain and movement control

impairment. J Bodyw Mov Ther 2015;19:722‑31.