Movement System Impairment-Based Classification Versus General Exercise for Chronic Low Back Pain: Protocol of a Randomized Controlled Trial.
BACKGROUND
Low back pain (LBP) is an important health problem in all developed countries and is associated with high levels of disability. Evidence-based clinical practice guidelines usually recommend different physical therapy interventions to manage this condition. However, those interventions usually result in small to moderate clinical effects. Recent studies suggest that interventions based on subgroup classifications may improve the effect sizes compared with rehabilitation programs where the same interventions were applied to all patients.


OBJECTIVE
This study will investigate the efficacy of treatment based on a Movement System Impairment (MSI)-based classification model for patients with chronic LBP compared with general exercise. The primary outcomes will be pain intensity and disability at 2 months after randomization.


METHODS
The study is a 2-arm, prospectively registered, randomized controlled trial with a blinded assessor.


METHODS
The study setting will be a university physical therapy clinic in Brazil.


METHODS
A total of 148 individuals with chronic LBP will participate in the study.


METHODS
Included individuals will be randomly allocated to participate in an 8-week treatment program based on the MSI-based classification or a general exercise program of stretching and strengthening exercises.


METHODS
Pain intensity, disability, and global impression of recovery will be assessed by a blinded assessor at baseline and at follow-up appointments after treatment (2 months) and 4 and 6 months after randomization.


CONCLUSIONS
Therapists will not be blinded.


CONCLUSIONS
The results of this study may contribute to a better understanding of the efficacy of treatments based on classification of participants with chronic LBP into subgroups.
D.C. Azevedo, PT, MSc, Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, and Physical Therapy Department, Pontifícia Universidade Católica de Minas Gerais, Dom José Gaspar 500, Belo Horizonte, MG, Brazil 30535-901. danielazevedo@pucminas.br.
Daniel Camara
DC
Azevedo
L.R. Van Dillen, PT, PhD, Program in Physical Therapy, Washington University School of Medicine, St Louis, Missouri.
Linda R
LR
Van Dillen
H.O. Santos, PT, Physical Therapy Department, Pontifícia Universidade Católica de Minas Gerais.
Henrique de Oliveira
Hde O
Santos
D.R. Oliveira, PT, Physical Therapy Department, Pontifícia Universidade Católica de Minas Gerais.
Daniel Ribeiro
DR
Oliveira
P.H. Ferreira, PT, PhD, Faculty of Health Sciences, University of Sydney, Sydney, Australia.
Paulo Henrique
PH
Ferreira
L.O.P. Costa, PT, PhD, Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, and Musculoskeletal Division, The George Institute for Global Health, Sydney, Australia.
Leonardo Oliveira Pena
LO
Costa
D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000145:classification* / Q000534:rehabilitation*; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000145:classification* / Q000534:rehabilitation*; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D009068:Movement; D010147:Pain Measurement; D012107:Research Design; D016037:Single-Blind Method