Article

Motor control exercises to improve control and coordination of trunk
muscles and graded activity under the principles of cognitive-behavioral therapy
are 2 commonly used exercise therapies, yet there is little evidence to support
the use of one intervention over the other. The objective of this
study was to compare the effectiveness of motor control exercises and graded
activity for patients with chronic nonspecific low back pain. DESIGN: This study
was a prospectively registered randomized controlled trial with outcome
assessment and statistical analyses conducted blind to group. SETTING: The study
was conducted in primary care settings. PATIENTS:
The participants were 172
patients with chronic (>12 weeks) nonspecific low back pain. INTERVENTIONS:
Patients were randomly assigned to receive either motor control exercises or
graded activity. There was no attempt to subclassify patients to match them to a
treatment. Patients in both groups received 14 sessions of individualized,
supervised exercise therapy. MEASUREMENTS: Primary outcomes were average pain
over the previous week (numeric rating scale) and function (Patient-Specific
Functional Scale); secondary outcomes were disability (24-item Roland-Morris
Disability Questionnaire), global impression of change (Global Perceived Effect
Scale), and quality of life (36-Item Short-Form Health Survey questionnaire
[SF-36]). Outcome measures were collected at baseline and at 2, 6, and 12 months
after intervention. RESULTS:
A linear mixed models analysis showed that there
were no significant differences between treatment groups at any of the time
points for any of the outcomes studied. For example, the effect for pain at 2
months was 0.0 (-0.7 to 0.8). LIMITATIONS: Clinicians could not be blinded to the
interventions. CONCLUSION: results of this study suggest that motor control
exercises and graded activity have similar effects for patients with chronic
nonspecific low back pain.

Langue : ANGLAIS