Background Chronic low back pain is one of the most common health problems and the treatment remains unclear. Motor control of trunk and pelvis is the main alteration found in subjects with low back pain and might be responsible of recurrence of symptoms. Recent studies have shown that improvement of trunk motor control is efficient to reduce of pain and increase of function in people with chronic low back pain (1). Trunk motor control can be recovered through stabilizing exercise that involves appropriate deep trunk muscle recruitment and functional training (1).
Objectives To compare the short-term results between trunk stabilizing exercise and strengthening exercise on pain, quality of life and function in patients with non-specific chronic low back pain
Methods 10 subjects with non-specific chronic low back pain were randomized into 2 groups: group A –strengthening exercise, group B – trunk stabilizing exercise. Strengthening exercise consisted in 3 steps: 1 – Correction of postural alignment; 2 – Stretching of the lower limbs muscles; 3 – Strengthening exercises of abdominal and lumbar spine muscles. Trunk stabilizing exercise involved 4 steps: 1 – Correction of postural alignment; 2 – Respiratory exercises associated with change of body positions (laying to sitting position, kneeling to semi-kneeling position and semi-kneeling to standing position); 3 – Motor training of trunk and pelvis through recruitment of transversus abdominis muscle, training of balance and postural adjustments with voluntary arm movement in different directions and body positions (sitting and standing); 4 – Training of challenging tasks as walking and stairs climbing with maintenance of trunk and pelvic alignment. Intervention was applied on two weekly sessions for 4 weeks with 50 minutes each session for both groups. Each group was conducted by 2 different professionals. A blinded professional conducted all evaluations for pain (Visual Analogic Scale, VAS), quality of life (SF-36) and function (Rolland-Morris Questionnaire, RMQ) before intervention and after treatment program. Kruskal Wallis test was used to compare the difference of variables between groups before treatment and to compare the increment or decrement of the variables after treatment (score before minus score after treatment).
Results There were no differences between groups before the treatment for VAS (p=0.598), all domains of SF-36 (p>0.05) and RMQ (p=0.751). Between groups comparison showed significant differences of decrement for VAS (p=0.023, Group A median=1 and Group B median=4), and for SF-36, significant increment for functional capacity (p=0.008, Group A median=-5 and Group B median=-25) and significant increment for emotional aspects (p=0.045, Group A median=0 and Group B median=-33) and marginal decrement for RMQ (p=0.059, Group A median=3 and Group B median=10).
Conclusions This pilot study showed that trunk stabilizing exercise showed better short-term results for pain, quality of life and function compared to strengthening exercise in subjects with non-specific chronic low back pain.
Tsao H, Galea MP, Hodges PW. Driving plasticity in the motor cortex in recurrent low back pain. European Journal of Pain, 2010. 14: 832–9.
Disclosure of Interest None Declared