Motor Control Exercise for Nonspecific Low Back Pain

Saragiotto, Bruno Tirotti; Maher, Christopher G.; Yamato, Tiê Parma; Costa, Leonardo Oliveira Pena; Ostelo, Raymond; Macedo, Luciana

doi:10.1097/brs.0000000000001645

Cited by 130 publications

(81 citation statements)

References 43 publications

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“…A meta-analysis from 2013 suggested that motor control exercises in patients with chronic or recurring LBP is superior to general exercises with regard to improved disability and pain [26]. However, a Cochrane review of motor control exercises for chronic non-specific LBP gave low to moderate evidence of pain reduction compared to minimal intervention [27]. …”

Section: Discussionmentioning

confidence: 99%

Impact of exercise programs among helicopter pilots with transient LBP

Andersen

Baardsen

Dalen

et al. 2017

BMC Musculoskelet Disord

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BackgroundFlight related low back pain (LBP) among helicopter pilots is frequent and may influence flight performance. Prolonged confined sitting during flights seems to weaken lumbar trunk (LT) muscles with associated secondary transient pain. Aim of the study was to investigate if structured training could improve muscular function and thus improve LBP related to flying.Methods39 helicopter pilots (35 men and 4 women), who reported flying related LBP on at least 1 of 3 missions last month, were allocated to two training programs over a 3-month period. Program A consisted of 10 exercises recommended for general LBP. Program B consisted of 4 exercises designed specifically to improve LT muscular endurance. The pilots were examined before and after the training using questionnaires for pain, function, quality of health and tests of LT muscular endurance as well as ultrasound measurements of the contractility of the lumbar multifidus muscle (LMM).ResultsApproximately half of the participants performed the training per-protocol. Participants in this subset group had comparable baseline characteristics as the total study sample. Pre and post analysis of all pilots included, showed participants had marked improvement in endurance and contractility of the LMM following training. Similarly, participants had improvement in function and quality of health. Participants in program B had significant improvement in pain, function and quality of health.ConclusionsThis study indicates that participants who performed a three months exercise program had improved muscle endurance at the end of the program. The helicopter pilots also experienced improved function and quality of health.Trial registrationIdentifier: NCT01788111 Registration date; February 5th, 2013, verified April 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1631-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Impact of exercise programs among helicopter pilots with transient LBP

Andersen

Baardsen

Dalen

et al. 2017

BMC Musculoskelet Disord

View full text Add to dashboard Cite

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“…This comprised consideration of five domains: risk of bias, inconsistency of results, indirectness, imprecision, and other applicable factors (eg, publication bias). Quality of evidence began as high for each meta‐analysis, and was reduced by one classification level for each domain not met in the comparison: 1) >25% of participants were from studies with high risk of bias; 2) significant heterogeneity (I >50%); 3) >50% of participants outside target group; 4) <400 participants for continuous variables, and <300 events for binary data; and 5) other (eg, publication bias). Conversely, quality of evidence was raised one classification level if a large effect size (ie, ≥0.8 was observed .…”

Section: Methodsmentioning

confidence: 99%

Cervical spine findings on MRI in people with neck pain compared with pain‐free controls: A systematic review and meta‐analysis

Farrell

Smith

Hancock

et al. 2019

Magnetic Resonance Imaging

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Background There is uncertainty regarding the clinical significance of findings on MRI in patients with whiplash associated disorder (WAD) or nonspecific neck pain (NSNP). Purpose To compare the presence of cervical spine MRI findings in people with WAD or NSNP with pain‐free controls. Study Type Systematic review and meta‐analysis. Population Adults with WAD (n = 994), NSNP (n = 715), or pain‐free controls (n = 2323). Field Strength 0.5T, 1.5T, and 3.0T. Assessment Medline, EMBASE, CINAHL, Web of Science, SCOPUS, and Cochrane CENTRAL databases were searched. Two independent reviewers identified studies for inclusion and extracted data. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross‐Sectional Studies. Overall quality of the evidence from meta‐analysis was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation approach. Statistical Tests Meta‐analysis was performed using a random‐effects model to calculate odds ratios or standard mean differences (SMDs) for binary and continuous data. Results In total, 31 studies were included (eight comparing acute WAD to controls, 14 comparing chronic WAD to controls, 12 comparing chronic NSNP to controls) comprising 4032 participants. Rectus capitis posterior major cross‐sectional area was smaller in people with chronic NSNP than controls (two studies: SMD –1.18 [95% confidence interval [CI] –1.65, –0.71]). The remaining meta‐analysis comparisons showed no group differences in MRI findings. The quality of evidence was mostly low due to small sample sizes and high heterogeneity. Data Conclusion Given the typically low‐quality evidence, definitive conclusions cannot be drawn on the presence of MRI findings in individuals with WAD or NSNP compared with pain‐free controls. Level of Evidence: 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018.

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“…37 We reduced the quality of evidence by 1 level for each domain not met in the comparison to determine the [ research report ] overall quality rating of the evidence for each meta-analysis performed.…”

Section: Quantitative Data Synthesis and Analysismentioning

confidence: 99%