title: A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: Short-term results of a randomised controlled trial.
abstract: BACKGROUND
  Exercise is an effective treatment for patients with sub-acute and chronic low back pain (LBP). Patients with a movement control impairment (MCI) can be diagnosed as a subgroup of patients with LBP. Unknown is which exercise intervention is most beneficial for this subgroup. This study assessed the short-term effect of a specific exercise program targeting movement control impairment versus general exercise treatment on disability in patients with LBP and MCI.
  
  
  METHODS
  In a multicentre parallel group randomised controlled pragmatic trial, patients with sub-acute and chronic LBP were included. Further inclusion criteria were disability of ≥5 points on the Roland-Morris Disability Questionnaire and ≥2 positive tests out of a set of 6 movement control impairment tests. A total of 106 patients were randomly assigned to either tailored movement control exercise intervention (MC, n = 52) or a general exercise intervention (GE, n = 54); both 9-18 individual treatment sessions, over a maximum of 12 weeks. The primary outcome was disability measured with the Patient Specific Functional scale (PSFS). Secondary outcome was the Roland-Morris disability scale (RMDQ). Measurements were taken pre- and posttreatment.
  
  
  RESULTS
  No significant difference was found following the treatment period. Baseline-adjusted between-group mean difference for the PSFS was 0.5 (SD = 0.5; p = 0.32) in favour of MC exercises. The Roland-Morris Disability Questionnaire revealed a significant, but not clinically relevant, between-group difference of 2.0 points (SD = 0.8; p = 0.01).
  
  
  CONCLUSIONS
  Disability in LBP patients was reduced considerably by both interventions. However, the limited contrast between the two exercise programs may have influenced outcomes.
authors.affiliation: ZHAW School of Health Professions, Institute of Physiotherapy, Winterthur, Switzerland; CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands. Electronic address: jeannette.saner@zhaw.ch.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Saner
authors.affiliation: CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands; Maastricht University, Dept. of Anatomy & Embryology, Maastricht, The Netherlands.
authors.forename: Judith M
authors.initials: JM
authors.lastname: Sieben
authors.affiliation: ZHAW School of Health Professions, Institute of Physiotherapy, Winterthur, Switzerland.
authors.forename: Jan
authors.initials: J
authors.lastname: Kool
authors.affiliation: ZHAW School of Health Professions, Institute of Physiotherapy, Winterthur, Switzerland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Luomajoki
authors.affiliation: CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands; Maastricht University Dept. of Epidemiology, Maastricht, The Netherlands.
authors.forename: Carolien H G
authors.initials: CHG
authors.lastname: Bastiaenen
authors.affiliation: CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands; Maastricht University Dept. of Epidemiology, Maastricht, The Netherlands.
authors.forename: Rob A
authors.initials: RA
authors.lastname: de Bie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016037:Single-Blind Method; D055815:Young Adult
keywords: Clinical trial; Exercise; Low back pain; Movement control impairment; Patient specific functional scale; Posture; Randomised controlled trial; Rehabilitation