Quality of Systematic Reviews on Specific Spinal Stabilization Exercise for Chronic Low Back Pain

Abstract

Study Design Systematic literature review. Objective To evaluate the quality of systematic reviews (SRs) on specific stabilization exercises for chronic low back pain (LBP). Background Multiple SRs regarding the effectiveness of lumbar stabilization exercises for people with chronic LBP have been published. As more SRs are published, the more it is recognized that, like other forms of research, methodological quality affects the validity of, and conclusions drawn from, the data. Methods A search of MEDLINE, CINAHL, and Embase was completed. Additionally, the PEDro database was screened and hand searching was completed. Included SRs had to contain randomized controlled trials examining a specific stabilization exercise program for the treatment of chronic LBP. Additionally, the assessed outcome measures had to include pain and/or disability measures. Literature reviews and clinical practice guidelines were excluded. Three reviewers independently assessed each SR for methodological quality. Results The search produced 665 SRs for review, of which 8 fulfilled the inclusion criteria. Consensus quality assessment scores ranged from 13/26 to 26/26, with an average of 20.7 points. Percent agreement and kappa values for individual criteria scores ranged from 50% to 92% and 0.25 to 0.85, respectively. Agreement was moderate to substantial across individual items, except for criterion 1. The intraclass correlation coefficient for overall score was 0.98 (95% confidence interval: 0.96, 0.99). Conclusion This review of SRs identified several high-quality reviews that indicated some benefit of specific stabilization exercise programs for patients with nonspecific chronic LBP. Level of Evidence Therapy, level 1a. J Orthop Sports Phys Ther 2013;43(4):242–250. Epub 14 January 2013. doi:10.2519/jospt.2013.4346

Spinal Stabilization Exercise Effectiveness for Low Back Pain in Adolescent Idiopathic Scoliosis

“…10,11 Specifically, a spinal stabilization program designed to activate the deep abdominal and back extensor muscles prevented recurrent episodes of LBP in adults, 12 but the effects of these spinal stabilization exercises have not been studied in AIS. Currently, 2 common physical therapy (PT) practices are used for managing LBP in AIS: (1) a supervised program of spinal stabilization exercises for 4 to 8 weeks, and (2) a 1-time treatment or instruction in spinal stabilization exercises with no follow-up.…”

A randomized controlled trial comparing McKenzie therapy and motor control exercises on the recruitment of trunk muscles in people with chronic low back pain: a trial protocol

“…Directional preference (based on the McKenzie approach) exercises utilizing repeated end range movements in a specific direction are also recommended in the APTA and Danish guidelines [10,11]. Efficacy for MDT and motor control exercises for treatment of chronic LBP has been demonstrated in systematic reviews of the literature [12][13][14].…”

Comparison of electromyographic activities of lumbar iliocostalis and lumbar multifidus muscles during stabilization exercises in prone, quadruped, and sitting positions

“…Of individuals with chronic low back pain, 30% receive physical therapy2 ) . Rehabilitation programs that include stabilization exercises reduce pain and disability in individuals with chronic low back pain3 ) . Both lumbar iliocostalis (LI) and lumbar multifidus (LM) have a role in stabilization of the spine.…”