Randomized Trial of General Strength and Conditioning Versus Motor Control and Manual Therapy for Chronic Low Back Pain on Physical and Self-Report Outcomes
Tagliaferri, S. D., Miller, C. T., Ford, J. J., Hahne, A. J., Main, L. C., Rantalainen, T., Connell, D. A., Simson, K. J., Owen, P. J., & Belavy, D. L. (2020). Randomized Trial of General Strength and Conditioning Versus Motor Control and Manual Therapy for Chronic Low Back Pain on Physical and Self-Report Outcomes. Journal of Clinical Medicine, 9(6), Article 1726. https://doi.org/10.3390/jcm9061726
Published inJournal of Clinical Medicine
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Exercise and spinal manipulative therapy are commonly used for the treatment of chronic low back pain (CLBP) in Australia. Reduction in pain intensity is a common outcome; however, it is only one measure of intervention efficacy in clinical practice. Therefore, we evaluated the effectiveness of two common clinical interventions on physical and self-report measures in CLBP. Participants were randomized to a 6‑month intervention of general strength and conditioning (GSC; n = 20; up to 52 sessions) or motor control exercise plus manual therapy (MCMT; n =20; up to 12 sessions). Pain intensity was measured at baseline and fortnightly throughout the intervention. Trunk extension and flexion endurance, leg muscle strength and endurance, paraspinal muscle volume, cardio‑respiratory fitness and self-report measures of kinesiophobia, disability and quality of life were assessed at baseline and 3- and 6-month follow-up. Pain intensity differed favoring MCMT between-groups at week 14 and 16 of treatment (both, p = 0.003), but not at 6-month follow‑up. Both GSC (mean change (95%CI): −10.7 (−18.7, −2.8) mm; p = 0.008) and MCMT (−19.2 (−28.1, −10.3) mm; p < 0.001) had within-group reductions in pain intensity at six months, but did not achieve clinically meaningful thresholds (20mm) within- or between‑group. At 6-month follow-up, GSC increased trunk extension (mean difference (95% CI): 81.8 (34.8, 128.8) s; p = 0.004) and flexion endurance (51.5 (20.5, 82.6) s; p = 0.004), as well as leg muscle strength (24.7 (3.4, 46.0) kg; p = 0.001) and endurance (9.1 (1.7, 16.4) reps; p = 0.015) compared to MCMT. GSC reduced disability (−5.7 (‑11.2, −0.2) pts; p = 0.041) and kinesiophobia (−6.6 (−9.9, −3.2) pts; p < 0.001) compared to MCMT at 6‑month follow-up. Multifidus volume increased within-group for GSC (p = 0.003), but not MCMT or between-groups. No other between-group changes were observed at six months. Overall, GSC improved trunk endurance, leg muscle strength and endurance, self-report disability and kinesiophobia compared to MCMT at six months. These results show that GSC may provide a more diverse range of treatment effects compared to MCMT. ...
Publication in research information system
MetadataShow full item record
- Liikuntatieteiden tiedekunta 
Additional information about fundingThis project was supported by internal institutional funding (to D.L.B.).
Showing items with similar title or keywords.
Effectiveness of a 12-month home-based exercise program on trunk muscle strength and spine function after lumbar spine fusion surgery : a randomized controlled trial Ilves, Outi; Neva, Marko H.; Häkkinen, Keijo; Dekker, Joost; Järvenpää, Salme; Kyrölä, Kati; Häkkinen, Arja (Taylor & Francis, 2020)Purpose: The effectiveness of a 12-month home-exercise program on trunk muscle strength after lumbar spine fusion surgery was evaluated. Materials and methods: Three months postoperatively, 98 patients were randomized ...
Exercise for the intervertebral disc : a 6-month randomised controlled trial in chronic low back pain Owen, Patrick J.; Miller, Clint T.; Rantalainen, Timo; Simson, Katherine J.; Connell, David; Hahne, Andrew J.; Trudel, Guy; Ford, Jon J.; Belavy, Daniel L. (Springer, 2020)Background context Muscle, bone and tendon respond anabolically to mechanical forces. Whether the intervertebral disc (IVD) can benefit from exercise is unclear. Purpose To examine whether exercise can beneficially ...
Physical disability in community-dwelling older people after hip fracture : randomized controlled trials with physical rehabilitation Edgren, Johanna (University of Jyväskylä, 2013)
Effectiveness of Distance Technology in Promoting Physical Activity in Cardiovascular Disease Rehabilitation : Cluster Randomized Controlled Trial, A Pilot Study Hakala, Sanna; Kivistö, Heikki; Paajanen, Teemu; Kankainen, Annaliisa; Anttila, Marjo-Riitta; Heinonen, Ari; Sjögren, Tuulikki (JMIR Publications Inc., 2021)Background: Physical activity is beneficial for cardiovascular rehabilitation. Digitalization suggests using technology in the promotion of physical activity and lifestyle changes. The effectiveness of distance technology ...
Enhanced rehabilitation guidance after arthroscopic capsulolabral repair of the shoulder : a randomized controlled trial Multanen, Juhani; Kiuru, Pauli; Piitulainen, Kirsi; Ylinen, Jari; Paloneva, Juha; Häkkinen, Arja (Sage Publications, 2020)Objective: To compare the effects of a 12-month home-based exercise program to usual care in patients after arthroscopic capsulolabral repair of the shoulder. Design: Randomized controlled trial. Setting: Outpatient ...