Individualized Low-Load Motor Control Exercises and Education Versus a High-Load Lifting Exercise and Education to Improve Activity, Pain Intensity, and Physical Performance in Patients With Low Back Pain: A Randomized Controlled Trial

Abstract

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

Periodized resistance training for persistent non-specific low back pain: A mixed methods feasibility study

“…Only a few previous studies have used periodization and heavy resistance training for LBP (10)(11)(12)(13)(14).…”

Analysis of Patient Outcomes Using the MyoKinesthetic System for the Treatment of Low Back Pain: A Case Series

“…In a study examining the effects of motor control exercises on LBP, Aasa et al 49 reported a mean PSFS baseline score of 3.8 and a 2-month follow-up score of 7.8. Similarly, Macedo et al 47 reported a baseline PSFS score of 3.7 and a 2-month follow-up score of 5.9 in patients treated with motor control exercises.…”

Physical Activity Might Be of Greater Importance for Good Spinal Control Than If You Have Had Pain or Not

“…34 The spine is, however, controlled by a complex interplay of many muscles, and this might be the reason why the specific features of exercises, which are addressed in books and research studies, differ. Some approaches highlight exercises targeting the deeper muscles of the trunk, 1 whereas others highlight correction of movement faulty movement pattern.…”