Study Design Systematic literature review. Objective To evaluate the quality of systematic reviews (SRs) on specific stabilization exercises for chronic low back pain (LBP). Background Multiple SRs regarding the effectiveness of lumbar stabilization exercises for people with chronic LBP have been published. As more SRs are published, the more it is recognized that, like other forms of research, methodological quality affects the validity of, and conclusions drawn from, the data. Methods A search of MEDLINE, CINAHL, and Embase was completed. Additionally, the PEDro database was screened and hand searching was completed. Included SRs had to contain randomized controlled trials examining a specific stabilization exercise program for the treatment of chronic LBP. Additionally, the assessed outcome measures had to include pain and/or disability measures. Literature reviews and clinical practice guidelines were excluded. Three reviewers independently assessed each SR for methodological quality. Results The search produced 665 SRs for review, of which 8 fulfilled the inclusion criteria. Consensus quality assessment scores ranged from 13/26 to 26/26, with an average of 20.7 points. Percent agreement and kappa values for individual criteria scores ranged from 50% to 92% and 0.25 to 0.85, respectively. Agreement was moderate to substantial across individual items, except for criterion 1. The intraclass correlation coefficient for overall score was 0.98 (95% confidence interval: 0.96, 0.99). Conclusion This review of SRs identified several high-quality reviews that indicated some benefit of specific stabilization exercise programs for patients with nonspecific chronic LBP. Level of Evidence Therapy, level 1a. J Orthop Sports Phys Ther 2013;43(4):242–250. Epub 14 January 2013. doi:10.2519/jospt.2013.4346

LBP generators are difficult to establish using traditional clinical examination techniques. The combined use of clinical criteria, using an LBP subgroup system, and baseline outcomes measures should guide treatment. Benchmarks should be guided by established MCID values for each instrument.

This finding suggests that these tests may measure different qualities of muscle performance and provides preliminary support for their use. Further evaluation of these assessments with clinical populations is necessary.

Low back pain (LBP) is one of the most prevalent and expensive health care problems in the United States. Studies suggest that stabilization exercise may be effective in the management of people with LBP. To accurately assess the effect of stabilization programs on muscle performance, clinicians need an objective measure that is both valid and reliable. The purpose of this study was to determine whether the double limb lowering test (DLLT) and lower abdominal muscle progression (LAMP) can detect a change in abdominal muscle performance after stabilization exercises. Eleven healthy participants (4 men and 7 women) were randomly assigned to either a specific stabilization exercise (SSE) or general stabilization exercise (GSE) group and were evaluated by the DLLT and LAMP before, during, and at the end of 8 weeks of training. Subjects attended exercise sessions twice per week over 8 weeks. No significant difference in pretest performance existed between the 2 groups. No significant difference was detected with the DLLT for either the SSE or GSE over time or when groups were combined. The LAMP detected a significant difference for the combined groups and GSE but not SSE over time. These data indicate that the LAMP is sensitive to change after a spinal stabilization program, whereas the DLLT does not detect a change after these programs. Furthermore, the GSE was more effective in producing these changes. Additional testing of these assessments is necessary to further validate these tests and to identify specific populations for which these tests may be most appropriate.

Background and Purpose. Near-peer (NP) teaching, teaching by students where a gap greater than 1 year exists between teacher and learner, has been found to produce positive results in both teacher and learner alike. Gross anatomy courses often include NP teaching experiences; however, those experiences tend to limit the NP teachers to strong academic performers. Method/Model Description and Evaluation. The University of South Florida School of Physical Therapy and Rehabilitation Sciences' Doctor of Physical Therapy (DPT) students participated in a NP teaching experience. All third-year DPT students served as a NP teacher, as either a planner (n = 31) or a laboratory assistant (n = 8). Third-year students were responsible for content development (planners) and/or delivery (planners and laboratory assistants) for an anatomy module within a movement science course. After each module, first-year students completed a survey and course assessments while third-year planners completed a self-reflection. A thematic analysis was completed using the first- and third-year responses. Outcomes. First-year students reported that the experience enhanced their understanding of anatomy as it relates to physical therapist practice, provided them strategies to correctly identify important anatomical concepts, and was preferable over instructor led anatomy. Third-year students (planners) acknowledged the benefit of teaching peers and reflected on knowledge reinforcement with a greater level of comfort and understanding of effort for teaching. Discussion and Conclusion. The findings support the existing literature that NP opportunities are beneficial for NP teachers and learners and have potential as an additional strategy for teaching human anatomy in physical therapist education programs.