title: What is the effect of sensory discrimination training on chronic low back pain? A systematic review.
abstract: BACKGROUND
  Sensory discrimination training (SDT) for people with chronic low back pain (CLBP) is a novel approach based on theories of the cortical reorganization of the neural system. SDT aims to reverse cortical reorganization, which is observed in chronic pain patients. SDT is still a developing therapeutic approach and its effects have not been systematically reviewed. The aim of this systematic review was to evaluate if SDT decreases pain and improves function in people with CLBP.
  
  
  METHODS
  A systematic review was performed on the available literature to evaluate the effects of SDT. Randomised controlled trials compared the effectiveness of SDT on pain and function in people with CLBP with the effectiveness of other physiotherapy interventions, no treatment, or sham therapy. The methodological quality of the included studies and the clinical relevance of reported treatment effects were investigated.
  
  
  RESULTS
  The original search revealed 42 records of which 6 fulfilled the inclusion criteria. The majority of studies showed that SDT caused statistically significant improvements in pain and function, but only two studies reported clinically relevant improvements. The applied SDT varied considerably with regard to dosage and content. The methodological quality of the included studies also varied, which hampered the comparability of results.
  
  
  CONCLUSIONS
  Although SDT seems to improve pain and function in people with CLBP, study limitations render firm conclusions unsafe. Future studies should pay closer attention to power and sample selection as well as to the content and dosage of the SDT intervention. We recommend a large, well-powered, prospective randomized control study that uses a standardized SDT approach to address the hypothesis that SDT causes clinically relevant improvements in pain and function.
authors.affiliation: Institute of Physiotherapy, Department of Health, Zurich University of Applied Sciences, Technikumstrasse 71, 8400, Winterthur, Switzerland.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kälin
authors.affiliation: Institute of Physiotherapy, Department of Health, Zurich University of Applied Sciences, Technikumstrasse 71, 8400, Winterthur, Switzerland.
authors.forename: Anne-Kathrin
authors.initials: AK
authors.lastname: Rausch-Osthoff
authors.affiliation: Institute of Physiotherapy, Department of Health, Zurich University of Applied Sciences, Technikumstrasse 71, 8400, Winterthur, Switzerland. christoph.bauer@zhaw.ch.|University of Tampere, School of Medicine, Kalevantie 4, FI-33014, Tampere, Finland. christoph.bauer@zhaw.ch.
authors.forename: Christoph Michael
authors.initials: CM
authors.lastname: Bauer
mesh_terms: D059350:Chronic Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004192:Discrimination, Psychological; D056228:Feedback, Sensory; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D010147:Pain Measurement; D058748:Pain Perception; D017288:Pain Threshold; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: Low Back pain; Physical therapy; Rehabilitation; Sensory feedback training; Systematic review