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Open AccessArticle

Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects

1
Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, 60487 Frankfurt am Main, Germany
2
University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, 14469 Potsdam, Germany
3
Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany
4
Department of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
5
University Hospital Carl Gustav Carus at Technical University Dresden, 01307 Dresden, Germany
6
Sociology of Physical Activity and Health, University of Potsdam, 14469 Potsdam, Germany
7
Centre for Clinical Research, Department of Trauma and Orthopaedic Surgery, Unfallkrankenhaus Berlin, 12683 Berlin, Germany
8
Orthopädiezentrum Theresie, 80339 München, Germany
9
Pain Management, Center of Orthopaedics and Trauma Surgery, Heidelberg University Hospital, 69118 Heidelberg, Germany
10
Department of Sports Medicine and Sports Nutrition, Ruhr-University Bochum, 44801 Bochum, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(9), 3058; https://doi.org/10.3390/jcm9093058
Received: 10 September 2020 / Accepted: 21 September 2020 / Published: 22 September 2020
(This article belongs to the Special Issue Improved Rehabilitation for Patients with Chronic Pain)
Low-to-moderate quality meta-analytic evidence shows that motor control stabilisation exercise (MCE) is an effective treatment of non-specific low back pain. A possible approach to overcome the weaknesses of traditional meta-analyses would be that of a prospective meta-analyses. The aim of the present analysis was to generate high-quality evidence to support the view that motor control stabilisation exercises (MCE) lead to a reduction in pain intensity and disability in non-specific low back pain patients when compared to a control group. In this prospective meta-analysis and sensitivity multilevel meta-regression within the MiSpEx-Network, 18 randomized controlled study arms were included. Participants with non-specific low back pain were allocated to an intervention (individualized MCE, 12 weeks) or a control group (no additive exercise intervention). From each study site/arm, outcomes at baseline, 3 weeks, 12 weeks, and 6 months were pooled. The outcomes were current pain (NRS or VAS, 11 points scale), characteristic pain intensity, and subjective disability. A random effects meta-analysis model for continuous outcomes to display standardized mean differences between intervention and control was performed, followed by sensitivity multilevel meta-regressions. Overall, 2391 patients were randomized; 1976 (3 weeks, short-term), 1740 (12 weeks, intermediate), and 1560 (6 months, sustainability) participants were included in the meta-analyses. In the short-term, intermediate and sustainability, moderate-to-high quality evidence indicated that MCE has a larger effect on current pain (SMD = −0.15, −0.15, −0.19), pain intensity (SMD = −0.19, −0.26, −0.26) and disability (SMD = −0.15, −0.27, −0.25) compared with no exercise intervention. Low-quality evidence suggested that those patients with comparably intermediate current pain and older patients may profit the most from MCE. Motor control stabilisation exercise is an effective treatment for non-specific low back pain. Sub-clinical intermediate pain and middle-aged patients may profit the most from this intervention. View Full-Text
Keywords: motor control exercise; stabilization; chronic low back pain; unspecific low back pain; exercise; lumbago; lumbalgia; meta-analysis; nonspecific; LBP; sensorimotor motor control exercise; stabilization; chronic low back pain; unspecific low back pain; exercise; lumbago; lumbalgia; meta-analysis; nonspecific; LBP; sensorimotor
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Niederer, D.; Engel, T.; Vogt, L.; Arampatzis, A.; Banzer, W.; Beck, H.; Moreno Catalá, M.; Brenner-Fliesser, M.; Güthoff, C.; Haag, T.; Hönning, A.; Pfeifer, A.-C.; Platen, P.; Schiltenwolf, M.; Schneider, C.; Trompeter, K.; Wippert, P.-M.; Mayer, F. Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects. J. Clin. Med. 2020, 9, 3058.

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