OBJECTIVES: To investigate the feasibility and effects of a sensorimotor stabilization exercise intervention with and without behavioral treatment in nonspecific low back pain. DESIGNS: A three-armed multicenter randomized controlled trial. Settings: Five study sites across Germany (3 orthopedic university outpatient clinics, 1 university sports medicine department, and 1 clinical institution). PARTICIPANTS: Six hundred and sixty-two volunteers (n = 662) (59% females, age 39 +/- 13y) with low back pain. Interventions: Sensorimotor training (SMT), sensorimotor training with behavioral therapy (SMT PLUS BT), and usual care group (UCG; continuation of the already ongoing individual treatment regime). Intervention groups performed a 12-week (3wk center-based, 9wk home-based) program. MAIN OUTCOME MEASURES: Adherence, dropout rates, adverse events, and intervention effects on pain intensity, disability, and trunk torque (gain scores, repeated measures analysis of variance, alpha-level < 0.05). RESULTS: In total, 220 participants received SMT, 222 received SMT PLUS BT, and 170 were analyzed as UCG. Dropout rates were 10% for SMT and SMT PLUS BT at week 3, 31% and 30% at week 4, and 49% and 50% at week 12. Adherence rates above 80% were reached in both interventions; 134 adverse events occurred. Intervention effects compared to UCG were found for pain intensity (SMT, p = 0.011, effect size d 0.41), disability (SMT PLUS BT, p = 0.020, d 0.41), and peak torque (SMT, p = 0.045, d 0.38; SMT PLUS BT, p = 0.019, d 0.44), with overall small effect sizes. CONCLUSIONS: Participants were highly adherent to the sensorimotor exercise, but showed increased dropout rates, particularly during home-based training. Both interventions proved to be feasible, and although only SMT showed an increased effect on pain intensity compared to UCG, the SMT PLUS BT showed positive effects on disability. Both interventions led to increases in strength, indicative of a neuromuscular adaptation.

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