Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review

Steiger, F.; Wirth, Brigitte; Bruin, Eling D. de; Mannion, Anne F.

doi:10.1007/s00586-011-2045-6

Cited by 143 publications

(102 citation statements)

References 88 publications

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“…Future studies are needed to better understand the specific and non-specific nature of interventions for CLBP [42][43][44][45] and also to aid the general practitioner in his/her decision on what intervention may be most appropriate. Further studies are warranted to evaluate the underlying physiological and psychological mechanisms in CLBP in order to better address these underlying abnormalities with the most effective treatment.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of a modified clinical prediction rule for use with spinal manipulative therapy in patients with chronic low back pain: a randomized clinical trial

et al. 2014

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Background: Spinal Manipulative Therapy (SMT) and Active Exercise Therapy (AET) have both demonstrated efficacy in the treatment of Chronic Lower Back Pain (CLBP). A Clinical Prediction Rule (CPR) for responsiveness to SMT has been validated in a heterogeneous lower back pain population; however there is a need to evaluate this CPR specifically for patients with CLBP, which is a significant source of disability. Methods: We conducted a randomized controlled trial (RCT) in Veteran Affairs and civilian outpatient clinics evaluating a modification of the original CPR (mCPR) in CLBP, eliminating acute low back pain and altering the specific types of SMT to improve generalizability. We enrolled and followed 181 patients with CLBP from 2007 to 2010. Patients were randomized by status on the mCPR to undergo either SMT or AET twice a week for four weeks. Providers and statisticians were blinded as to mCPR status. We collected outcome measures at 5, 12 and 24-weeks post baseline. We tested our study hypotheses by a general linear model repeated measures procedure following a univariate analysis of covariance approach. Outcome measures included, Visual Analogue Scale, Bodily pain subscale of SF-36 and the Oswestry Disability Index, Patient Satisfaction and Patient Expectation.

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Section: Resultsmentioning

confidence: 99%

Evaluation of a modified clinical prediction rule for use with spinal manipulative therapy in patients with chronic low back pain: a randomized clinical trial

et al. 2014

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“…Interpretation of these findings is not straightforward, and in none of the studies were other aspects of physical function or psychological attributes assessed that might otherwise have helped to explain the changes in clinical outcome after treatment. As suggested for other types of exercise therapy [55], it is conceivable that the mechanism of action for this type of treatment does not concern trunk muscle function or segmental stabilisation, per se, and instead resides in some other positive influence of the treatment programme such as improvements in self-efficacy, coping strategies, catastrophising, or fear-avoidance [33,52], changes in cortical organisation [14,66] or simply a positive therapist-patient interaction/relationship [19].…”

Section: Introductionmentioning

confidence: 99%

Spine stabilisation exercises in the treatment of chronic low back pain: a good clinical outcome is not associated with improved abdominal muscle function

et al. 2012

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Neither baseline lateral abdominal muscle function nor its improvement after a programme of stabilisation exercises was a statistical predictor of a good clinical outcome. It is hence difficult to attribute the therapeutic result to any specific effects of the exercises on these trunk muscles. The association between changes in catastrophising and outcome serves to encourage further investigation on larger groups of patients to clarify whether stabilisation exercises have some sort of "central" effect, unrelated to abdominal muscle function per se.

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“…Boa parte dos efeitos induzidos pelo exercício físico, como o aumento da massa muscular, a melhora do sistema cardiovascular, a redução da incidência de doenças e a liberação de opióides endógenos, como as beta-endorfinas, devem-se principalmente às adaptações induzidas sobre os diversos sistemas corporais de melhoria da sua eficiência fisiológica (32) .…”

Section: Discussionunclassified

Atividade física comunitária: efeitos sobre a funcionalidade na lombalgia crônica

Martins¹,

Longen²

2017

RBPS

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Este artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho seja corretamente citado. ATIVIDADE FÍSICA COMUNITÁRIA: EFEITOS SOBRE A FUNCIONALIDADE NA LOMBALGIA CRÔNICACommunity physical activity: effects on functionality in chronic low back pain Actividad física en la comunidad: efectos sobre la funcionalidad en la lumbalgia crónica Maicon da Silva MartinsUniversidade do Extremo Sul Catarinense -UNESC -Santa Catarina (SC) -Brasil Willians Cassiano LongenUniversidade do Extremo Sul Catarinense -UNESC -Santa Catarina (SC) -Brasil RESUMO Objetivo: Avaliar a intensidade dolorosa, a força lombar e a funcionalidade de indivíduos que possuem lombalgia crônica inespecífica e são praticantes de um programa públicos de exercícios físicos. Métodos: Pesquisa exploratória, transversal e quantitativa realizada em 2017, com 130 mulheres de 30 a 60 anos de idade e sem histórico de cirurgia na coluna vertebral. Aplicou-se o Oswestry Low Back Pain Disability Questionnaire (ODQ) para a avaliação da incapacidade relacionada à coluna lombar. Quantificou-se a dor através da escala visual analógica (EVA) e a força muscular lombar com dinamometria lombar (Takei®). Resultados: Das 130 participantes, 97,7% (n=127) apresentaram incapacidade funcional mínima relacionada à coluna lombar (ODQ). Em relação à força, 16,9% (n=10) apresentaram valores normais e 83,1% (n=120) abaixo dos valores de referência, apresentando fraqueza muscular. Quanto à intensidade da dor, 47,7% (n=67) das participantes apresentaram intensidade leve, 45,5% (n=59) apresentaram intensidade moderada e 6,9% (n=9), intensa. Conclusão: O programa possui características que contribuem para manter controlada a intensidade dolorosa, que vem se mostrando baixa, bem como a incapacidade funcional significativa dos indivíduos. A fraqueza muscular na região lombar, apresentada pelas participantes sem associação com a funcionalidade, e a dor podem ser um fator que perpetua os quadros de lombalgia crônica. Os achados sugerem a necessidade de revisão da prescrição terapêutica dos exercícios do programa realizado. (ODQ). In respect to strength, 16.9% (n=10) presented normal values and 83.1% (n=120) were below the reference values, presenting muscle weakness. As for the pain intensity, 47.7% (n=67)

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Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review

Cited by 143 publications

References 88 publications

Evaluation of a modified clinical prediction rule for use with spinal manipulative therapy in patients with chronic low back pain: a randomized clinical trial

Evaluation of a modified clinical prediction rule for use with spinal manipulative therapy in patients with chronic low back pain: a randomized clinical trial

Spine stabilisation exercises in the treatment of chronic low back pain: a good clinical outcome is not associated with improved abdominal muscle function

Atividade física comunitária: efeitos sobre a funcionalidade na lombalgia crônica

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