Use the Back button in your browser to see the other results of your search or to select another record.

Detailed Search Results

Randomized trial of general strength and conditioning versus motor control and manual therapy for chronic low back pain on physical and self-report outcomes
Tagliaferri SD, Miller CT, Ford JJ, Hahne AJ, Main LC, Rantalainen T, Connell DA, Simson KJ, Owen PJ, Belavy DL
Journal of Clinical Medicine 2020 Jun;9(6):1726
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Exercise and spinal manipulative therapy are commonly used for the treatment of chronic low back pain (CLBP) in Australia. Reduction in pain intensity is a common outcome; however, it is only one measure of intervention efficacy in clinical practice. Therefore, we evaluated the effectiveness of two common clinical interventions on physical and self-report measures in CLBP. Participants were randomized to a 6-month intervention of general strength and conditioning (GSC; n = 20; up to 52 sessions) or motor control exercise plus manual therapy (MCMT; n = 20; up to 12 sessions). Pain intensity was measured at baseline and fortnightly throughout the intervention. Trunk extension and flexion endurance, leg muscle strength and endurance, paraspinal muscle volume, cardio-respiratory fitness and self-report measures of kinesiophobia, disability and quality of life were assessed at baseline and 3- and 6-month follow-up. Pain intensity differed favoring MCMT between-groups at week 14 and 16 of treatment (both, p = 0.003), but not at 6-month follow-up. Both GSC (mean change (95%CI) -10.7 (-18.7 to -2.8) mm; p = 0.008) and MCMT (-19.2 (-28.1 to -10.3) mm; p < 0.001) had within-group reductions in pain intensity at six months, but did not achieve clinically meaningful thresholds (20 mm) within- or between-group. At 6-month follow-up, GSC increased trunk extension (mean difference (95% CI) 81.8 (34.8 to 128.8) s; p = 0.004) and flexion endurance (51.5 (20.5 to 82.6) s; p = 0.004), as well as leg muscle strength (24.7 (3.4 to 46.0) kg; p = 0.001) and endurance (9.1 (1.7 to 16.4) reps; p = 0.015) compared to MCMT. GSC reduced disability (-5.7 (-11.2 to -0.2) pts; p = 0.041) and kinesiophobia (-6.6 (-9.9 to -3.2) pts; p < 0.001) compared to MCMT at 6-month follow-up. Multifidus volume increased within-group for GSC (p = 0.003), but not MCMT or between-groups. No other between-group changes were observed at six months. Overall, GSC improved trunk endurance, leg muscle strength and endurance, self-report disability and kinesiophobia compared to MCMT at six months. These results show that GSC may provide a more diverse range of treatment effects compared to MCMT.

Full text (sometimes free) may be available at these link(s):      help