title: The effect of motor control and tactile acuity training on patients with non-specific low back pain and movement control impairment.
abstract: BACKGROUND
  Movement control impairment is a clinical subgroup of non-specific low back pain which can be assessed reliably. There is a strong correlation between tactile acuity and movement control suggesting these two treatments might have additive effects. The first research aim was to determine if patients with a motor control impairment demonstrated improvement in outcome with combined tactile acuity and motor control training. The second aim was to determine if tactile acuity training enhanced the effect of motor control training.
  
  
  METHODS
  The primary study was a single-arm cohort study conducted in three physiotherapy practices in the German-speaking part of Switzerland. 40 patients (23 males and 17 females) suffering from non-specific low back pain (NSLBP) and movement control impairment were treated. Patients were assessed at baseline and immediately post treatment. Treatment included exercises to lumbopelvic control and graphesthesia training to improve tactile acuity. Treatment effects were evaluated using the Roland Morris disability questionnaire (RMQ) and the patient-specific functional scale (PSFS). The performance on a set of six movement control tests and lumbar two-point discrimination were also assessed. The results of this cohort study were compared with a historic control group which was comparable with the primary study but included only motor control exercises.
  
  
  RESULTS
  All the outcomes improved significantly with the combined training (RMQ - 2.2 pts., PSFS - 2.8 pts.; MCTB - 2.02 pts. & TPD - 17.07 mm; all p < 0.05). In comparison to the outcomes of the historic control, there was no significant differences in movement control, patient-specific functional complaints or disability between the groups.
  
  
  CONCLUSIONS
  The results of this study, based on a before and after intervention comparison, showed that outcome improved significantly following combined tactile acuity and motor control training. However, compared to an earlier study, the tactile acuity training did not have an additional effect to the results. The use of historical controls does not control for allocation bias and the results obtained here require verification in a randomized controlled trial.
authors.affiliation: Physiotherapie Seen, Landvogt-Waserstrasse 65, CH-8405 Winterthur, Switzerland; Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, Technikumstrasse 71, CH-8401 Winterthur, Switzerland. Electronic address: maegigutknecht@bluewin.ch.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Gutknecht
authors.affiliation: Medbase, Brunngass 6, CH-8400 Winterthur, Switzerland; Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, Technikumstrasse 71, CH-8401 Winterthur, Switzerland. Electronic address: amannig@gmx.ch.
authors.forename: Angelika
authors.initials: A
authors.lastname: Mannig
authors.affiliation: Physiotherapie Erlenbach, Lerchenbergstarsse 39, CH-8703 Erlenbach, Switzerland; Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, Technikumstrasse 71, CH-8401 Winterthur, Switzerland. Electronic address: family.strebel@ggaweb.ch.
authors.forename: Anja
authors.initials: A
authors.lastname: Waldvogel
authors.affiliation: School of Physiotherapy, The University of Notre Dame Australia, 19 Mouat St, Fremantle WA 6959, Australia. Electronic address: benedict.wand@nd.edu.au.
authors.forename: Benedict M
authors.initials: BM
authors.lastname: Wand
authors.affiliation: Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, Technikumstrasse 71, CH-8401 Winterthur, Switzerland. Electronic address: luom@zhaw.ch.
authors.forename: Hannu
authors.initials: H
authors.lastname: Luomajoki
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D026741:Physical Therapy Modalities
keywords: Disability; Graphaesthesia; Movement control impairment; Non-specific low back pain; Two-point discrimination