Motor control exercise for symptomatic lumbar disc herniation: protocol for a systematic review and meta-analysis.
BACKGROUND
Lumbar disc herniation (LDH) is a common condition in adults and can impose a heavy burden on both the individual and society. It is defined as displacement of disc components beyond the intervertebral disc space. Various conservative treatments have been recommended for the treatment of LDH and physical therapy plays a major role in the management of patients. Therapeutic exercise is effective for relieving pain and improving function in individuals with symptomatic LDH. The aim of this systematic review is to evaluate the effectiveness of motor control exercise (MCE) for symptomatic LDH.


METHODS
We will include all clinical trial studies with a concurrent control group which evaluated the effect of MCEs in patients with symptomatic LDH. We will search PubMed, SCOPUS, PEDro, SPORTDiscus, CINAHL, CENTRAL and EMBASE with no restriction of language. Primary outcomes of this systematic review are pain intensity and functional disability and secondary outcomes are functional tests, muscle thickness, quality of life, return to work, muscle endurance and adverse events. Study selection and data extraction will be performed by two independent reviewers. The assessment of risk of bias will be implemented using the PEDro scale. Publication bias will be assessed by funnel plots, Begg's and Egger's tests. Heterogeneity will be evaluated using the I2statistic and the χ2test. In addition, subgroup analyses will be conducted for population and the secondary outcomes. All meta-analyses will be performed using Stata V.12 software.


BACKGROUND
No ethical concerns are predicted. The systematic review findings will be published in a peer-reviewed journal and will also be presented at national/international academic and clinical conferences.


BACKGROUND
CRD42016038166.
Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran.
Mohammad Reza
MR
Pourahmadi
Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Morteza
M
Taghipour
Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran.
Ismail
I
Ebrahimi Takamjani
Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences and Health Services, Tehran, Iran.
Mohammad Ali
MA
Sanjari
Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Faculty of Allied Health Sciences, University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan.
Mohammad Ali
MA
Mohseni-Bandpei
Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences and Health Services, Tehran, Iran.
Abbas Ali
AA
Keshtkar
Disc herniation; Lumbar; Motor control exercise; Physical therapy; Stabilization; Systematic review
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