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 Based on data from 29 previously conducted trials involving a total
of 2,431 adults aged 22 to 55 years, the study team also found that
people who exercised generally experienced more improvements in pain
and disability than those who didn’t.
“The choice of exercise should be based on patient or therapist
preferences and costs, as the current evidence suggests that there
is no difference among the types of exercises,” said lead study
author Bruno Saragiotto of the George Institute for Global Health at
Sydney Medical School in Australia.
Lower back pain is one of the leading causes of disability and
doctor visits for adults worldwide, and the condition also has a
significant economic impact in lost wages and productivity.
While the findings add to a growing body of evidence for the
importance of physical activity to treat lower back pain, more
research is still needed to determine which workout routines might
be best suited to specific patients or injuries, Saragiotto and
colleagues conclude in the journal Cochrane Library.
Motor control exercise focuses on activation of the deep trunk
muscles and targets restoration of control and coordination of these
muscles, which support the spine.
Workouts can vary, but patients might start off working on balance
and flexibility and then progress to more complex exercises that
involve lifting, pushing, pulling and rotating the body.
For the current analysis, researchers looked at studies ranging in
size from 20 to 323 participants, most of whom were middle-aged.
The duration of treatment programs ranged from 20 days to 12 weeks,
and the number of exercise sessions ranged from one to five per
week.
Sixteen of the studies compared motor control exercise to other
types of physical activity. Seven studies compared it to minimal
intervention, five examined it relative to manual therapy such as
massage or chiropractic work, three assessed it as an alternative to
exercise paired with treatments such as electrical stimulation, and
one looked at whether it worked as well as home exercise.
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When researchers compared pain and disability outcomes across all of
these studies, they found motor control exercises were similar to
other activities at intervals between three and 12 months.
It’s possible that some patients with structural or behavioral
changes in the muscles of the spine might be a subgroup of people
who could benefit most from motor control exercises, Saragiotto
said. But one shortcoming of the analysis is it didn’t pinpoint
precisely who might be the ideal patient for this type of approach.
Researchers also lacked enough quality data to assess whether motor
control exercise might be better than electrotherapy paired with
other types of activity, Saragiotto noted.
One reason all exercises appeared equal in this analysis might also
be tied in part to mental health, noted Julie Fritz, a physical
therapy researcher at the University of Utah in Salt Lake City who
wasn’t involved in the study.
“It may be that the non-specific effects of exercise are responsible
for the benefit, in other words, being active, doing something for
your back pain helps individuals feel more in control of the
condition and has positive physical and psychological benefits
regardless of exactly what sort of exercise is being done,” Fritz
said by email.
SOURCE: http://bit.ly/1Na4Jnt Cochrane Library, online January 7,
2016.
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