Effects of McGill stabilization exercises and conventional physiotherapy on pain, functional disability and active back range of motion in patients with chronic non-specific low back pain

Abstract

[Purpose] The aim of this study was to compare the effects of “McGill stabilization exercises” and “conventional physiotherapy” on pain, functional disability and active back flexion and extension range of motion in patients with chronic non-specific low back pain. [Subjects and Methods] Thirty four patients with chronic non-specific low back pain were randomly assigned to McGill stabilization exercises group (n=17) and conventional physiotherapy group (n=17). In both groups, patients performed the corresponding exercises for six weeks. The visual analog scale (VAS), Quebec Low Back Pain Disability Scale Questionnaire and inclinometer were used to measure pain, functional disability, and active back flexion and extension range of motion, respectively. [Results] Statistically significant improvements were observed in pain, functional disability, and active back extension range of motion in McGill stabilization exercises group. However, active back flexion range of motion was the only clinical symptom that statistically increased in patients who performed conventional physiotherapy. There was no significant difference between the clinical characteristics while compared these two groups of patients. [Conclusion] The results of this study indicated that McGill stabilization exercises and conventional physiotherapy provided approximately similar improvement in pain, functional disability, and active back range of motion in patients with chronic non-specific low back pain. However, it appears that McGill stabilization exercises provide an additional benefit to patients with chronic non-specific low back, especially in pain and functional disability improvement.

Dose-response-relationship of stabilisation exercises in patients with chronic non-specific low back pain: a systematic review with meta-regression

“…All included studies adopted a randomised controlled design (RCT). The main inclusion criterion was (chronic) non-specific low back pain ≥ 4 weeks 22 , ≥ 6 weeks 23 , ≥ 7 weeks 24 , ≥ 8 weeks [25][26][27] , ≥ 12 weeks , ≥ 24 weeks [56][57][58] and ≥ 2 year history 59 , whilst in 11 [60][61][62][63][64][65][66][67][68][69][70] studies this information was not presented. The baseline pain, effect sizes (Cohen's d, stabilisation exercise group only) for pain and disability are presented in Table 3.…”

“…1 Ctrl. 2 LBP ≥ 12 weeks 240, 80, 80, 80 51.9 ± 15.3, 54.8 ± 15.3, 54.0 ± 14.4 165/75 VAS (0–10), 6.3 ± 2.0, 6.5 ± 2.1, 6.2 ± 2.0 4: 0; 8, 24; 48 VAS (0–10) 0.92 RMDQ SE: 1.15 Franca, 2012 36 RCT, 2 SE Ctrl LBP ≥ 12 weeks 30, 15, 15 42.1 ± 8.2, 41.5 ± 4.4 N.A VAS (0–10), 5.94 ± 1.56, 6.35 ± 1.51 2: 0; 6 VAS (0–10) SE: 3.77 ODI SE: 3.83 Ghorbanpour, 2018 57 RCT, 2 SE Ctrl LBP ≥ 24 weeks 30, 15, 15 23.8 ± 3.5, 20.9 ± 1.2 16/14 VAS (0–10), 29.5 ± 4.8, 28.3 ± 6.5 2: 0; 6 VAS (0–100) SE: 0.94 Persian version of the Quebec Low Back Pain Disability Scale Questionnaire SE: 0.33 Hosseinifar, 2013 37 RCT, 2 SE Ctrl LBP ≥ 12 weeks 30, 15, 15 40.1 ± 10.8, 36.6 ± 8.2 N.A VAS (0–100), 4.33 ± 1.58, 4.40 ± 1.95 2: 0; 6 VAS (0–100) d = 1.77 FRI questionnaire d = 1.45 Hwang, 2013 71 RCT, 3 SE Ctrl. 1 Ctrl.…”

“…All interventions and the comparators are described. The stabilisation exercises are called core stability exercise 25 , 27 , 30 – 32 , 47 , 51 , 54 , 61 – 63 , 69 , motor control exercise 24 , 35 , 38 , 44 , 45 , 48 , 50 , stabilisation 23 , 26 , 28 , 34 , 41 , 52 , 55 , 60 , lumbar stabilisation exercise 39 , 46 , 56 , 64 , 67 , spinal stabilisation 33 , 37 , 68 , sensorimotor training 66 , 71 , trunk stability exercise 49 , 58 , Swiss ball stabilisation 43 , 65 , 70 , perturbation training 29 , sling training 53 , McGill stabilisation exercise 40 , 57 , segmental stabilisation exercise 36 , neuromuscular exercise 22 , multifidus muscle retraining 59 and Pilates-based exercise 42 . The intervention period ranged between 2 69 and 24 22 weeks with a mean of 7.0 ± 3.3 weeks.…”

“…In addition to this, only 23 22,25,28,[30][31][32][33][34][35][38][39][40][41]43,45,[49][50][51]53,54,56,58,63,[67][68][69][70][71] studies reported on the number of repetitions per set per exercise, with a range of 6 23,24,26,27,36,38,42,44,[46][47][48][50][51][52]55,57,[59][60][61][64][65][66]69 to 30 66 repetitions (mean: 13.6 ± 5.6 repetition...…”

Efficacy of Silver Needle Therapy for The Treatment of Chronic Nonspecific Low Back Pain: A Prospective, Single-Center, Randomized, Parallel-Controlled Clinical Trial

“…Base on a review, Cuenca-Martínez et al [5] found that classical physiotherapy procedures were ineffective in the treatment of chronic nonspeci c low back pain. Ghorbanpour et al [23] reported that conventional physiotherapy was not as effective as exercise in reducing pain and improving function in patients with low back pain. The study showed that dry needling provided more therapeutic bene ts compared with classical physiotherapy for patients with low back pain [24] , although there was no follow-up period to evaluate the long-term effects.…”