Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review

Abstract

BackgroundProprioceptive training (PrT) is popularly applied as preventive or rehabilitative exercise method in various sports and rehabilitation settings. Its effect on pain and function is only poorly evaluated. The aim of this systematic review was to summarise and analyse the existing data on the effects of PrT on pain alleviation and functional restoration in patients with chronic (≥3 months) neck- or back pain.MethodsRelevant electronic databases were searched from their respective inception to February 2014. Randomised controlled trials comparing PrT with conventional therapies or inactive controls in patients with neck- or low back pain were included. Two review authors independently screened articles and assessed risk of bias (RoB). Data extraction was performed by the first author and crosschecked by a second author. Quality of findings was assessed and rated according to GRADE guidelines. Pain and functional status outcomes were extracted and synthesised qualitatively and quantitatively.ResultsIn total, 18 studies involving 1380 subjects described interventions related to PrT (years 1994–2013). 6 studies focussed on neck-, 12 on low back pain. Three main directions of PrT were identified: Discriminatory perceptive exercises with somatosensory stimuli to the back (pPrT, n = 2), multimodal exercises on labile surfaces (mPrT, n = 13), or joint repositioning exercise with head-eye coordination (rPrT, n = 3). Comparators entailed usual care, home based training, educational therapy, strengthening, stretching and endurance training, or inactive controls. Quality of studies was low and RoB was deemed moderate to high with a high prevalence of unclear sequence generation and group allocation (>60%). Low quality evidence suggests PrT may be more effective than not intervening at all. Low quality evidence suggests that PrT is no more effective than conventional physiotherapy. Low quality evidence suggests PrT is inferior to educational and behavioural approaches.ConclusionsThere are few relevant good quality studies on proprioceptive exercises. A descriptive summary of the evidence suggests that there is no consistent benefit in adding PrT to neck- and low back pain rehabilitation and functional restoration.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-382) contains supplementary material, which is available to authorized users.

The effectiveness of home-based exercise programs for low back pain patients

“…Home-based exercise programs are a practical, economic, and long-term effective treatment method for chronic back pain, and are as effective as standard physical treatment methods, indeed even more effective in the long term12, 15,16,17,18 ) . The effects of exercise are a decrease in kinesiophobia, the prevention of recurrence, and a decrease in disability.…”

Interrelationship between postural balance and body posture in children and adolescents

“…On the other hand, Mazaheri et al52 ) did not identify any interrelationship between postural sway and lower back pain in their comprehensive review. Likewise, McCaskey et al16 ) showed in a review that proprioceptive exercises did not have any additional effect in the therapy of lower back pain patients. Therefore, therapy of posture weaknesses for the prophylaxis of back pain must be considered separately from therapeutic measures to improve balance skills.…”

Microcurrent Point Stimulation Applied to Lower Back Acupuncture Points for the Treatment of Nonspecific Neck Pain

“…Although it is well supported that abdominal exercising and improved core strength reduce neck pain, 39,40 the consistency of neck pain outcomes produced through the treatment of acupuncture points of the standard protocol suggests that there may be a stronger relationship between neck pain and lower back and leg acupuncture points than the literature reports. It is of interest that the effect of a single application as per protocol continued to show further pain reduction at the 48-h postevaluation.…”