A randomized controlled trial on the efficacy of physical exercise in patients braced for instability of the lumbar spine.
OBJECTIVE
Spinal instability is often disregarded as a cause of chronic low back pain and until now there has been no agreement as to its definition and on its nosologic importance or as to a conservative therapeutic protocol. The authors aim to verify whether possible symptomatological characteristics are reflected in radiological findings and, although there is no univocal opinion on the utilization of orthoses of containment for unstable segments, they also aim to verify their efficacy on pain control and neuromotor performance when employed in isolation or in association with the most reliable rehabilitation techniques.


METHODS
Forty-eight patients between the ages of 30 and 50 were entered in the study, selected with special exclusion criteria and appropriately randomized to a group following kinesitherapy (KT) and orthoses (O) (O+KT group) and to a control group (orthoses [O] group); the symptomatological and instrumental characteristics were studied at time intervals 0 (t0), 3 months (t3), 6 months (t6), and 12 months (12t).


RESULTS
The samples examined present homogeneous characteristics. Lumbar instability pain is related to the presence of shift and not to hypermobility, when the latter is guided by efficient neuromotor feedback. In the O+KT group, treatment achieves the two-fold results of reducing shift and increasing mobility in the absence of pain. Both groups tend to increase the utilization of a brace over time. Furthermore, in the O+KT group, a marked reduction in the use of medicine is noticed.


CONCLUSIONS
Following treatment both groups report a decrease in pain even though the results of neuromotor performance prove to be better in the group following KT.
Celestini
M
M
Department of Physical Medicine and Rehabilitation, RM/A-RM/E, S. Spirito in Sassia Hospital, Rome, Italy.
Marchese
A
A
Serenelli
A
A
Graziani
G
G
D000328:Adult; D001915:Braces; D003131:Combined Modality Therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000534:rehabilitation*; D017116:Low Back Pain / Q000534:rehabilitation*; D008159:Lumbar Vertebrae; D008875:Middle Aged; D016896:Treatment Outcome