Effectiveness of motor control exercise on non-specific chronic low back pain, disability and core muscle morphological characteristics: a meta-analysis of randomized controlled trials

Zhang, Chanjuan; Li, Yuelong; Zhong, Yi; Feng, Chenyang; Zhang, Zhou; Wang, Chuhuai

doi:10.23736/s1973-9087.21.06555-2

Cited by 11 publications

(23 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…or max 10–12 Exercise EPA: sessions, 12x/30 min, 20 × 30 min, 35 × 40 min Telerehabiltation: 1x/day, phone calls 2x/wks Wang et al (2012) [ 57 ] SR: 5 MA: 4 Number of subjects: 494 Definition: Chronic LBP (longer than 3 mo) Duration: ≥ 3 mo % Women : NR Age: NR Core stability training is described as the reinforcement of the ability to insure stability of the neutral spine position. Core stability exercises were usually performed on labile devices, such as an air-filled disc, a low-density mat, a wobble board, or a Swiss ball Training period: 12 sessions over 8 wks, 1 session/wk for 8 wks, 1 session/wk for 8 wks, 2 sessions/wk for 6 wks, 1 session/wk for 8 wks GE; strengthening, stretch and aerobic exercises, trunk strengthening and stretching, exercises, superficial strengthening exercises ( n = 15), trunk strengthening and stretching exercises, physical exercises ( n = 40) Training period: 12 treatment sessions over 8 wk, 1 session/wk for 8 wk over 8 wks, 1 session/wk for 8 wks, 2 sessions/wk for 6 wks, 1 session/wk for 8 wks Zhang et al (2021) [ 58 ] SR: 18 MA: 18 Number of subjects: 1098 Definition: Non-specific chronic low back pain (NSCLBP) Duration: Pain duration or recurrence more than ≥ 12wks Women : 42% Age: 23–55 yrs MCE (e.g ., trunk stability exercise, core stability exercises, stabilization exercise, perturbation-based therapy) that target specific trunk muscles to improve control of the spine and pelvic Length of session: 25–90 min Number of intervention sessions: 4–24 Training period: 1–13 wks. 1–3 sessions/wks Sham treatment/placebo treatment (minimal intervention such as no intervention), hands-on therapies (spinal manipulative therapy/manual therapy) and other hands-off therapies (other exercises).…”

Section: Resultsmentioning

confidence: 99%

“…Based on the AMSTAR-2 ratings, we found 13 SRs with high quality [ 15 , 16 , 18 – 20 , 47 , 56 , 58 , 65 , 69 – 71 , 77 ], 16 with moderate quality [ 14 , 17 , 43 , 45 , 46 , 48 , 52 – 54 , 59 , 60 , 62 , 67 , 68 , 78 ], 14 with low quality [ 39 , 40 , 49 – 51 , 57 , 61 , 63 , 64 , 66 , 73 – 76 ], and two with critically low quality [ 13 , 72 ]. The AMSTAR-2 ratings for all included publications are presented in Table 11 .…”

Section: Resultsmentioning

confidence: 99%

“… Wang et al (2012) [ 57 ] AMSTAR-2 Low Pain: VAS, NRS Disability: RM, ODI Follow-up: Short term: < 3 mo Intermediate: 6 mo Long term: ≥ 12 mo MCE > GE Short-term MD = -1.29 (95%CI -2.47; -0.11) MCE = GE No difference at intermediate or long-term MCE > GE Short-term MD = -7.14 (95%CI -11.64; -2.65) MCE = GE No difference at intermediate or long-term Compared to GE, MCE is more effective in decreasing pain and may improve physical function in patients with chronic LBP in the short-term but not in long-term. Zhang et al (2021) [ 58 ] AMSTAR2 High Pain NRS, VAS Disability RMDQ, ODI QLBPDSQ Follow up Posttreatment Intermediate 6 mo Long-term 12 and 24 mo MCE > other exercises Posttreatment (11 trials) WMD = -0.65 (95%CI -1.05; -0.25) MCE = other exercises Intermediate 6 months (2 trials) WMD = -0.09 (95%CI -0.31; 0.14) Long-term 12 mo (3 trials) WMD = -0.13 (95%CI -0.32; 0.06) MCE = MT Posttreatment (4 trials) WMD = -0.06 (95%CI -0.26, 0.13) Intermediate 6 mo (2 trials) WMD = 0.25 (95%CI -0.48; 0.01) Long-term 12 mo (1 trial) WMD = 0.00 (95%CI -0.33; 0.33) Long term 24 mo (1 trial) WMD = -0.08 (95%CI -0.54; 0.38) MCE > MI Posttreatment (4 trials) WMD = -0.44 (95%CI -0.78, -0.09) MCE = MI Intermediate 6 mo (2 trials) WMD = -0.23 (95%CI -0.49; 0.04) Long-term 12 mo (1 trial) WMD = 0.04 (95%CI -0.31; 0.22) Long-term 24 mo (1 trial) WMD = -0.50 (95%CI -1.06; 0.07) MCE > other exercises Posttreatment (11 trials) WMD = -0.56 (95%CI -0.98; -0.18) MCE = other exercises Intermediate 6 mo (2 trials) WMD = -0.16 (95%CI -0.39; 0.07) Long-term 12 mo (2 trials) WMD = -0.10 (95%CI -0,33; 0.13) MCE = MT Posttreatment (4 trials) WMD = 0.12 (95%CI -0.10, 0.35) Intermediate 6 mo (2 trials) WMD = -0.07 (95%CI -0.30; 0.16) Long-term 12 mo (2 trials) WMD = -0.16 (95%CI -0.39; 0.08) Long-term 24 mo (1 trial) WMD = -0.19 (95%CI -0.66; 0.27) MCE > MI Posttreatment (4 trials) WMD = -0.70 (95%CI -1.40, -0.01) MCE = MI Intermediate 6 mo (2 trials) WMD = -0.15 (95%CI -0.41; 0.12) Long-term 12 mo (2 trial) WMD = -0.12 (95%CI -0.38; 0.14) Long-term 24 mo (1 trial) WMD = -0.00 (95%CI -0.56; 0.56) Low to very low quality of evidence supported that MCE resulted in a reduction of pain and disability posttreatment than other treatments for NSCLBP. …”

Section: Resultsmentioning

confidence: 99%

“…All but one of our included SRs [ 40 ] conducted a meta-analysis. The publication year ranged from 2006 to 2021, and the last updated search was August 2020 [ 58 ]. The SRs investigating MCE included between four and 34 low-to-high-quality RCTs and included between 209 and 2514 participants (Table 11 ).…”

Section: Resultsmentioning

confidence: 99%

“…In total, 195 RCTs were included but, there was a high overlap of the included original studies (CCA 13%) since only 78 original trials were included. Only three of the included SRs were rated with an overall high quality [ 16 , 56 , 58 ].…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Summarizing the effects of different exercise types in chronic low back pain – a systematic review of systematic reviews

Grooten

Boström

Dedering

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background In chronic LBP (CLBP), guideline-endorsed treatment is to stay active, return to normal activity, and to exercise. Several reviews on various exercise types used in CLBP have been published. We aimed to identify systematic reviews of common exercise types used in CLBP, to appraise their quality, and to summarize and compare their effect on pain and disability. Methods We searched the databases OVID MEDLINE, EMBASE, COCHRANE LIBRARY, and WEB OF SCIENCE (Core collection) for systematic reviews and meta-analyses on adults between 18 and 70 years of age suffering from chronic or recurrent LBP for a period of at least 12 weeks, which investigated the effects of exercises on pain and disability. All searches were conducted without language restriction. The search was performed up until 2022–01-26. The included reviews were grouped into nine exercise types: aerobic training, aquatic exercises, motor control exercises (MCE), resistance training, Pilates, sling exercises, traditional Chinese exercises (TCE), walking, and yoga. The study quality was assessed with AMSTAR-2. For each exercise type, a narrative analysis was performed, and the level of evidence for the effects of exercise was assessed through GRADE. Results Our database search resulted in 3,475 systematic reviews. Out of the 253 full texts that were screened, we included 45 systematic reviews and meta-analyses. The quality of the included reviews ranged from high to critically low. Due to large heterogeneity, no meta-analyses were performed. We found low-to-moderate evidence of mainly short-term and small beneficial effects on pain and disability for MCE, Pilates, resistance training, TCE, and yoga compared to no or minimal intervention. Conclusions Our findings show that the effect of various exercise types used in CLBP on pain and disability varies with no major difference between exercise types. Many of the included systematic reviews were of low-to-moderate quality and based on randomized controlled trials with high risk of bias. The conflicting results seen, undermine the certainty of the results leading to very-low-to-moderate quality of evidence for our results. Future systematic reviews should be of higher quality to minimize waste of resources. Trial registration PROSPERO: Reg no 190409 Registration date 01AUG 2020.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Summarizing the effects of different exercise types in chronic low back pain – a systematic review of systematic reviews

Grooten

Boström

Dedering

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

Muscle-brain communication in pain: The key role of myokines

Wang

et al. 2022

Brain Research Bulletin

View full text Add to dashboard Cite

Functional Alterations of the Basal Ganglia Are Associated with Voluntary Activation of the Core Stabilizing Muscles in Patients with Chronic Low Back Pain: A Cross-Sectional Study

Zhang,

Chen,

Yin

et al. 2023

Pain Research and Management

Self Cite

View full text Add to dashboard Cite

Purpose. Deficits in voluntary activation of the core stabilizing muscles are consistently observed in patients with chronic low back pain (CLBP); however, the underlying neural mechanism remains unclear. This cross-sectional study aimed at testing the hypothesis that the impaired voluntary activation of core stabilizing muscles is associated with structural and functional alterations in the basal ganglia, thalamus, and cortex in patients with CLBP. Methods. We obtained structural and resting-state functional magnetic resonance imaging (rs-fMRI) data from 53 patients with CLBP and 67 healthy controls and estimated the alterations in grey matter volume (GMV) and functional and effective connectivity (EC) of regions with altered GMV via whole brain analysis. The voluntary activation of the multifidus (MF) and transversus abdominis (TrA) was evaluated by ultrasound imaging in these patients. Results. Compared with the HCs, they displayed a significant decrease in GMV in the bilateral thalamus and caudate nucleus, a significant increase in GMV in the left middle frontal gyrus, and increased resting-state functional connectivity between the right caudate nucleus and the bilateral precuneus (voxel-level p < 0.005 , Gaussian random field-corrected p < 0.05 ). The patients also showed increased EC from the right caudate nucleus to the bilateral precuneus, which was significantly correlated with voluntary activation of the bilateral MF and TrA (all p < 0.050 ). Conclusions. Grey matter alterations may be confined to regions responsible for perception, motor control, and emotion regulation in patients with CLBP. The interrupted EC from the basal ganglia to the default mode network might be involved in the impairment of voluntary activation of the core stabilizing muscles.

show abstract

Effectiveness of motor control exercise on non-specific chronic low back pain, disability and core muscle morphological characteristics: a meta-analysis of randomized controlled trials

Cited by 11 publications

References 56 publications

Summarizing the effects of different exercise types in chronic low back pain – a systematic review of systematic reviews

Summarizing the effects of different exercise types in chronic low back pain – a systematic review of systematic reviews

Muscle-brain communication in pain: The key role of myokines

Functional Alterations of the Basal Ganglia Are Associated with Voluntary Activation of the Core Stabilizing Muscles in Patients with Chronic Low Back Pain: A Cross-Sectional Study

Contact Info

Product

Resources

About