Study Design Randomized controlled trial. Background Low back pain is a common disorder. Patients with low back pain frequently have aberrant and pain-provocative movement patterns that often are addressed with motor control exercises. Objective To compare the effects of low-load motor control (LMC) exercise and those of a high-load lifting (HLL) exercise. Methods Seventy participants with recurrent low back pain, who were diagnosed with nociceptive mechanical pain as their dominating pain pattern, were randomized to either LMC or HLL exercise treatments. Participants were offered 12 treatment sessions over an 8-week period. All participants were also provided with education regarding pain mechanisms. Methods Participants were assessed prior to and following treatment. The primary outcome measures were activity (the Patient-Specific Functional Scale) and average pain intensity over the last 7 days (visual analog scale). The secondary outcome measure was a physical performance test battery that included 1 strength, 3 endurance, and 7 movement control tests for the lumbopelvic region. Results Both interventions resulted in significant within-group improvements in pain intensity, strength, and endurance. The LMC group showed significantly greater improvement on the Patient-Specific Functional Scale (4.2 points) compared with the HLL group (2.5 points) (P<.001). There were no significant between-group differences in pain intensity (P = .505), strength, and 1 of the 3 endurance tests. However, the LMC group showed an increase (from 2.9 to 5.9) on the movement control test subscale, whereas the HLL group showed no change (from 3.9 to 3.1) (P<.001). Conclusion An LMC intervention may result in superior outcomes in activity, movement control, and muscle endurance compared to an HLL intervention, but not in pain intensity, strength, or endurance. Registered at ClinicalTrials.gov (NCT01061632). Level of Evidence Therapy, level 2b-. J Orthop Sports Phys Ther 2015;45(2):77–85. doi:10.2519/jospt.2015.5021

Study DesignRandomized controlled trial ObjectiveThe aim of this study was to compare the effects of low-load motor control exercises and a high-load lifting exercise, on lumbar multifidus (LM) thickness on either side of the spine and whether the effects are affected by pain intensity or change in pain intensity, among patients with nociceptive mechanical LBP. Summary of Background DataThere is evidence that patients with low back pain may have a decreased size of the (LM) muscles with an asymmetry between sides in the lower back. It has also been shown that low-load motor control training can affect this asymmetry. It is, however, not known whether a high-load exercise has the same effect. MethodsSixty-five participants diagnosed with nociceptive mechanical low back painwere included and randomized into low-load motor control exercises or a high-load lifting exercise, the deadlift. The LM thickness was measured using rehabilitative ultrasound imaging, at baseline and after a 2-month training period. ResultsThere were no differences between interventions regarding effect on LM muscle thickness. However, the analysis showed a significant effect for asymmetry. The thickness of the LMmuscle on the small side increased significantly compared to the large side in both intervention groups, without influence of pain at baseline, or change in pain intensity. ConclusionsThere was a difference in thickness of the LM muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the LM muscles on the small side, irrespective of exercise load.The increase in LM thickness does not appear to be mediated by either current pain intensity or the magnitude of change in pain intensity. study 20 .Still, neither the thickness of the LM muscles, nor the effects of LMC and HLL on LM thicknessin patients with nociceptive mechanical LBP have been investigated previously.Theprimary aim of this study was therefore to investigate the LM thickness and compare the effects of LMC exercises and a HLL exercise, on LM thickness among patients with nociceptive mechanical LBP.Also, a secondary aim wasto investigate whether changesin LM thickness wasaffected by baseline or change in pain intensity. MATERIALS AND METHODS Study DesignThis study is part of a larger data collection evaluating the effects of LMC exercises and an HLL exercise (NCT01061632) 20 . Here, we investigated the effects on percentage change [(follow-upbaseline/baseline)*100] in thickness of the LM muscle at the fifth lumbar vertebra at the small and large sides. The study protocol was approved by The Regional Ethical Review Board in . ParticipantsConsecutive individuals seeking care for LBP with a duration of more than three months at two occupational health care centers, and classified as having nociceptive mechanical LBP 21 were screened for eligibility (n=85) 20 . The eligibility screening controlled for inclusion and exclusion criteria such as red-(i.e., pathological processes) and yellow flags (i.e., pain and pain behavior secondary...

No difference was observed between the high low load lifting and low load motor control interventions. Both interventions included retraining of movement patterns and pain education, which might explain the positive results over time.

Recent studies have indicated that the deadlift exercise may be effective in decreasing pain intensity and increasing activity for most, but not all, patients with a dominating pattern of mechanical low back pain. This study aimed to evaluate which individual factors measured at baseline could predict activity, disability, and pain intensity in patients with mechanical low back pain after an 8-week training period involving the deadlift as a rehabilitative exercise. Thirty-five participants performed deadlift training under the supervision of a physical therapist with powerlifting experience. Measures of pain-related fear of movement, hip and trunk muscle endurance, and lumbopelvic movement control were collected at baseline. Measures of activity, disability, and pain intensity were collected at baseline and at follow-up. Linear regression analyses were used to create models to predict activity, disability, and pain intensity at follow-up. Results showed that participants with less disability, less pain intensity, and higher performance on the Biering-Sørensen test, which tests the endurance of hip and back extensor muscles, at baseline benefit from deadlift training. The Biering-Sørensen test was the most robust predictor because it was included in all predictive models. Pain intensity was the next best predictor as it was included in 2 predictive models. Thus, for strength and conditioning professionals who use the deadlift as a rehabilitative exercise for individuals with mechanical low back pain, it is important to ensure that clients have sufficient back extensor strength and endurance and a sufficiently low pain intensity level to benefit from training involving the deadlift exercise.