Motor control exercise for chronic low back pain: a randomized placebo-controlled trial.
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.


METHODS
This was a randomized, placebo-controlled trial.


METHODS
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.


METHODS
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.


METHODS
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.
Costa
Leonardo O P
LO
Musculoskeletal Division, The George Institute for International Health, Sydney, New South Wales 2050, Australia. lcos3060@gmail.com
Maher
Christopher G
CG
Latimer
Jane
J
Hodges
Paul W
PW
Herbert
Robert D
RD
Refshauge
Kathryn M
KM
McAuley
James H
JH
Jennings
Matthew D
MD
D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009068:Movement; D010147:Pain Measurement; D011187:Posture; D020127:Recovery of Function