Peer Review #3 of "Effectiveness of specific stabilization exercise compared with traditional trunk exercise in women with non-specific low back pain: a pilot randomized controlled trial (v0.1)"

Abstract

Background. Non-specific low back pain (LBP) is the leading cause of disability worldwide. The primary physiotherapeutic treatment for LBP is physical exercise, but evidence suggesting a specific exercise as most appropriate for any given case is limited. Objective. To determine if specific stabilization exercise (SSE) is more effective than traditional trunk exercise (TTE) in reducing levels of pain, disability and inflammation in women with non-specific low back pain (LBP). Design. A pilot randomized controlled trial was conducted in Rovira i Virgili University, Catalonia. Methods. 39 females experiencing non-specific LBP were included in two groups: the TTE program and SSE program, both were conducted by a physiotherapist during twenty sessions. The primary outcome was pain intensity (10-cm Visual Analogue Scale). Secondary outcomes were disability (Roland Morris Disability Questionnaire), and inflammation (IL-6 and TNF-α plasma levels). Measurements were taken at baseline, at half intervention, at post-intervention, and a month later. Results: Mean group differences in change from baseline to post-intervention for TTE were:-4.5 points (CI 3.3 to 5.6) for pain,-5.1 points (CI 3.0 to 7.3) for disability, 0.19 pg/mL (95% CI-1.6 to 1.2) for IL-6 levels, and 46.2 pg/mL (CI 13.0 to 85.3) for TNF-α levels. For SSE, differences were:-4.3 points (CI 3.1 to 5.6) for pain,-6.1 points (CI 3.7 to 8.6) for disability, 1.1 pg/mL (CI 0.0 to 2.1) for IL-6 levels , and 12.8 pg/mL (95% CI-42.3 to 16.7) for TNF-α levels. There were an insignificant effect size and no statistically significant overall mean differences between both groups. Conclusion: This study suggests that both interventions (traditional trunk and specific stabilization exercises) are effective in reducing pain and disability in non-specific LBP patients, but the two programs produce different degrees of inflammation change. Clinical trial registration number: NCT02103036.