Vol. 89, No. 12, December 2009, pp. 1275-1286
DOI: 10.2522/ptj.20090218
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Research Reports |
Motor Control Exercise for Chronic Low Back Pain: A Randomized Placebo-Controlled Trial
L.O.P. Costa, PT, PhD, is Research Fellow, Musculoskeletal Division, The George Institute for International Health, PO Box M201, Missenden Rd, Sydney, New South Wales 2050, Australia.
C.G. Maher, PT, PhD, is Director, Musculoskeletal Division, The George Institute for International Health, and Professor, Sydney Medical School, The University of Sydney, Sydney, Australia.
J. Latimer, PT, PhD, is Senior Research Fellow, Musculoskeletal Division, The George Institute for International Health, and Associate Professor, Sydney Medical School, The University of Sydney.
P.W. Hodges, PhD, Bphty(Hons), is Professor and NHMRC Principal Research Fellow/Professorial Research Fellow, Division of Physiotherapy, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
R.D. Herbert, PT, PhD, is Senior Research Fellow, Musculoskeletal Division, The George Institute for International Health, and Associate Professor, Sydney Medical School, The University of Sydney.
K.M. Refshauge, DipPhty, GradDipManipTher, MBiomedE, PhD, is Director, Research & Innovation, and Deputy Dean, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
J.H. McAuley, PhD, is Research Manager, Musculoskeletal Division, The George Institute for International Health.
M.D. Jennings, PT (Hons), is Deputy Director, Physiotherapy Department, Liverpool Hospital, Sydney South West and Western Sydney Area Health Services, Sydney, Australia.
Address all correspondence to Dr Costa at: lcos3060{at}gmail.com.
Background: The evidence that exercise intervention is effective for treatment of chronic low back pain comes from trials that are not placebo-controlled.
Objective: The purpose of this study was to investigate the efficacy of motor control exercise for people with chronic low back pain.
Design: This was a randomized, placebo-controlled trial.
Setting: The study was conducted in an outpatient physical therapy department in Australia.
Patients: The participants were 154 patients with chronic low back pain of more than 12 weeks’ duration.
Intervention: Twelve sessions of motor control exercise (ie, exercises designed to improve function of specific muscles of the low back region and the control of posture and movement) or placebo (ie, detuned ultrasound therapy and detuned short-wave therapy) were conducted over 8 weeks.
Measurements: Primary outcomes were pain intensity, activity (measured by the Patient-Specific Functional Scale), and patient's global impression of recovery measured at 2 months. Secondary outcomes were pain; activity (measured by the Patient-Specific Functional Scale); patient's global impression of recovery measured at 6 and 12 months; activity limitation (measured by the Roland-Morris Disability Questionnaire) at 2, 6, and 12 months; and risk of persistent or recurrent pain at 12 months.
Results: The exercise intervention improved activity and patient's global impression of recovery but did not clearly reduce pain at 2 months. The mean effect of exercise on activity (measured by the Patient-Specific Functional Scale) was 1.1 points (95% confidence interval [CI]=0.3 to 1.8), the mean effect on global impression of recovery was 1.5 points (95% CI=0.4 to 2.5), and the mean effect on pain was 0.9 points (95% CI=–0.01 to 1.8), all measured on 11-point scales. Secondary outcomes also favored motor control exercise.
Limitation: Clinicians could not be blinded to the intervention they provided.
Conclusions: Motor control exercise produced short-term improvements in global impression of recovery and activity, but not pain, for people with chronic low back pain. Most of the effects observed in the short term were maintained at the 6- and 12-month follow-ups.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  P. C. Weiss On "Motor control exercise for chronic low back pain..." Costa LOP, Maher CG, Latimer J, et al. Phys Ther. 2009;89:1275-1286. Physical Therapy, February 1, 2010; 90(2): 307 - 307. [Full Text] [PDF]
|
|
|
|
|
|
D. L. Hart and M. W. Werneke On "Motor control exercise for chronic low back pain..." Costa LOP, Maher CG, Latimer J, et al. Phys Ther. 2009;89:1275-1286. Physical Therapy, February 1, 2010; 90(2): 308 - 310. [Full Text] [PDF]
|
|
|
|
|
|
L. O.P. Costa, C. G. Maher, J. Latimer, P. W. Hodges, R. D. Herbert, K. M. Refshauge, J. H. McAuley, and M. D. Jennings Author Response Physical Therapy, February 1, 2010; 90(2): 310 - 311. [Full Text] [PDF]
|
|
|
|
|
|
L. O.P. Costa, C. G. Maher, J. Latimer, P. W. Hodges, R. D. Herbert, K. M. Refshauge, J. H. McAuley, and M. D. Jennings Author Response Physical Therapy, February 1, 2010; 90(2): 307 - 308. [Full Text] [PDF]
|
|
|
|
|
|
J. M. Fritz Invited Commentary Physical Therapy, December 1, 2009; 89(12): 1287 - 1289. [Full Text] [PDF]
|
|
|
|
|
|
L. O.P. Costa, C. G. Maher, J. Latimer, P. W. Hodges, R. D. Herbert, K. M. Refshauge, J. H. McAuley, and M. D. Jennings Author Response Physical Therapy, December 1, 2009; 89(12): 1289 - 1291. [Full Text] [PDF]
|
|