Motor control exercises, when performed in conjunction with other forms of therapy, can significantly reduce pain and disability in patients with persistent low back pain, according to a new systematic review published in the January issue of Physical Therapy (PTJ), the scientific journal of the American Physical Therapy Association.
Patients who perform these types of exercises are able to be more physically active and experience positive effects over a longer period of time than those who receive other treatments, according to researchers.
Motor control exercise, also known as specific stabilization exercise, is a new form of exercise for back pain that has gained the attention of researchers and health practitioners over the past decade. The exercise focuses on regaining control of the trunk muscles, also known as the transversus abdominis and multifidus, which support and control the spine. Previous studies of patients with low back pain have shown they are unable to properly control these muscles. Through motor control exercise, patients are taught how to isolate and "switch on" these muscles and then incorporate the movements into their normal activities.
"Although the exercises seemed promising, until now we did not have clear evidence on whether or not they were more effective," says researcher Luciana G Macedo, PT, MSc, a PhD student at The George Institute for International Health, Sydney, Australia. "It is important to note that this form of exercise is different from going to the gym or going for a walk. The program relies upon a skilled clinician, such as a physical therapist, identifying the specific trunk muscles that are a problem and then working closely with patients to teach them how to get the muscles working properly again." Patients first learn to control the muscles in simple postures, and then in more challenging activities, aiming to get the muscles to work to control and support the spine in those activities that previously caused pain, she says.
In the United States, the treatment cost of back pain is estimated to be $86 billion per year, or 9% of the country’s total health expenditure, she says.
The report in PTJ systematically reviewed and then summarized 14 randomized, controlled trials, evaluating the effectiveness of motor control exercises for persistent, low back pain.
Macedo et al. Motor Control Exercise for Persistent, Nonspecific Low Back Pain: A Systematic Review. Physical Therapy, 2008; DOI: 10.2522/ptj.20080103
[Source: Science Daily]