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Randomized Trial of General Strength and Conditioning versus Motor Control and Manual Therapy for Chronic Low Back Pain on Physical and Self-Report Outcomes

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Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
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Advance HealthCare, 157 Scoresby Rd, Boronia, VIC 3155, Australia
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Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC 3083, Australia
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Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
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[email protected] Park, AAMI Park, 60 Olympic Boulevard, Melbourne, VIC 3004, Australia
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School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(6), 1726; https://doi.org/10.3390/jcm9061726
Received: 17 April 2020 / Revised: 28 May 2020 / Accepted: 1 June 2020 / Published: 3 June 2020
(This article belongs to the Section Epidemiology & Public Health)
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. View Full-Text
Keywords: exercise; spine; physiotherapy; physical therapy; rehabilitation exercise; spine; physiotherapy; physical therapy; rehabilitation
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MDPI and ACS Style

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. Randomized Trial of General Strength and Conditioning versus Motor Control and Manual Therapy for Chronic Low Back Pain on Physical and Self-Report Outcomes. J. Clin. Med. 2020, 9, 1726. https://doi.org/10.3390/jcm9061726

AMA Style

Tagliaferri SD, Miller CT, Ford JJ, Hahne AJ, Main LC, Rantalainen T, Connell DA, Simson KJ, Owen PJ, Belavy DL. 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. 2020; 9(6):1726. https://doi.org/10.3390/jcm9061726

Chicago/Turabian Style

Tagliaferri, Scott D.; Miller, Clint T.; Ford, Jon J.; Hahne, Andrew J.; Main, Luana C.; Rantalainen, Timo; Connell, David A.; Simson, Katherine J.; Owen, Patrick J.; Belavy, Daniel 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" J. Clin. Med. 9, no. 6: 1726. https://doi.org/10.3390/jcm9061726

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