Article

The evidence that exercise intervention is effective for treatment of
chronic low back pain comes from trials that are not placebo-controlled.
OBJECTIVE: The purpose of this study was to investigate the efficacy of motor
control exercise for people with chronic low back pain.
DESIGN: This was a
randomized, placebo-controlled trial. SETTING: The study was conducted in an
outpatient physical therapy department in Australia. Patients The participants
were 154 patients with chronic low back pain of more than 12 weeks' duration.
INTERVENTION: Twelve sessions of motor control exercise (ie, exercises designed
to improve function of specific muscles of the low back region and the control of
posture and movement) or placebo (ie, detuned ultrasound therapy and detuned
short-wave therapy) were conducted over 8 weeks. MEASUREMENTS: Primary outcomes
were pain intensity, activity (measured by the Patient-Specific Functional
Scale), and patient's global impression of recovery measured at 2 months.
Secondary outcomes were pain; activity (measured by the Patient-Specific
Functional Scale); patient's global impression of recovery measured at 6 and 12
months; activity limitation (measured by the Roland-Morris Disability
Questionnaire) at 2, 6, and 12 months; and risk of persistent or recurrent pain
at 12 months. RESULTS: The exercise intervention improved activity and patient's
global impression of recovery but did not clearly reduce pain at 2 months. The
mean effect of exercise on activity (measured by the Patient-Specific Functional
Scale) was 1.1 points (95% confidence interval [CI]=0.3 to 1.8), the mean effect
on global impression of recovery was 1.5 points (95% CI=0.4 to 2.5), and the mean
effect on pain was 0.9 points (95% CI=-0.01 to 1.8), all measured on 11-point
scales. Secondary outcomes also favored motor control exercise. Limitation
Clinicians could not be blinded to the intervention they provided. CONCLUSIONS:
Motor control exercise produced short-term improvements in global impression of
recovery and activity, but not pain, for people with chronic low back pain. Most
of the effects observed in the short term were maintained at the 6- and 12-month
follow-ups.

Langue : ANGLAIS