An update of stabilisation exercises for low back pain: A systematic review with meta-analysis

BMC Musculoskeletal Disorders

Volumn 15, Issue 1, 2014, Pages

  Smith, Benjamin E ^a   Littlewood, Chris ^b   May, Stephen ^c  

^a DERBY HOSPITALS NHS FOUNDATION TRUST   (United Kingdom)

^b UNIVERSITY OF SHEFFIELD   (United Kingdom)

^c SHEFFIELD HALLAM UNIVERSITY   (United Kingdom)

Author keywords

Core stability; Effectiveness; Exercise therapy; Low back pain; Meta analysis; Stabilisation; Systematic review; Treatment

Indexed keywords

ANALGESIA; ARTICLE; CLINICAL EFFECTIVENESS; DIATHERMY; DISABILITY; FOLLOW UP; HUMAN; KINESIOTHERAPY; LEG PAIN; LOW BACK PAIN; MANIPULATIVE MEDICINE; META ANALYSIS; MOTOR CONTROL; PAIN ASSESSMENT; PHYSIOTHERAPY; SPINE STABILIZATION; STABILISATION EXERCISE; SYSTEMATIC REVIEW; PROCEDURES; RANDOMIZED CONTROLLED TRIAL (TOPIC); TREATMENT OUTCOME; TRENDS;

EXERCISE THERAPY; HUMANS; LOW BACK PAIN; RANDOMIZED CONTROLLED TRIALS AS TOPIC; TREATMENT OUTCOME;

EID: 84924280108     PISSN: None     EISSN: 14712474     Source Type: Journal    
DOI: 10.1186/1471-2474-15-416     Document Type: Article

References (106)

1. Nachemson A, Jonsson E: Neck and Back Pain: The Scientific Evidence of Causes, Diagnosis, and Treatment. Philadelphia: Lippincott Williams and Wilkins; 2000.
2. Palmer KT, Walker-Bone K, Griffin MJ, Syddall H, Pannett B, Coggon D, Cooper C: Prevalence and occupational associations of neck pain in the British population. Scand J Work Environ Heal 2001, 27:49-56.
3. Walker BF: The prevalence of low back pain: A systematic review of the literature from 1966 to 1998. J Spinal Disord 2000, 13:205-217.
4. Hestbaek L, Leboeuf-Yde C, Manniche C: Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J 2003, 12:149-165.
5. Maniadakis N, Gray A: The economic burden of back pain in the UK. Pain 2000, 84:95-103.
6. National Institute for Health and Care Excellence: Low Back Pain. Early Management of Persistent Non-Specific Low Back Pain [CG88]. 2009.
7. Pain in Europe; A 2003 Report. 2003. http://www.paineurope.com.
8. Department of Health (DoH): The NHS Plan: A Plan for Investment a Plan for Reform. 2000:82.
9. Liddle SD, David Baxter G, Gracey JH: Physiotherapists' use of advice and exercise for the management of chronic low back pain: A national survey. Man Ther 2009, 14:189-196.
10. Hodges PW, Richardson CA: Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine (Phila Pa 1976) 1996, 21:2640-2650.
11. Hodges PW, Richardson CA: Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Arch Phys Med Rehabil 1999, 80:1005-1012.
12. Richardson C, Jull G, Hodges P, Hides J: Therapeutic Exercise for Spinal Segmental Stabilization: In Lower Back Pain. Edinburgh: Churchill Livingstone; 1999.
13. May S, Johnson R: Stabilisation exercises for low back pain: A systematic review. Physiotherapy 2008, 94(3):179-189.
14. Mannion AF, Pulkovski N, Schenk P, Hodges PW, Gerber H, Loupas T, Gorelick M, Sprott H: A new method for the noninvasive determination of abdominal muscle feedforward activity based on tissue velocity information from tissue Doppler imaging. J Appl Physiol 2008, 104:1192-1201.
15. Vasseljen O, Fladmark AM, Westad C, Torp HG: Onset in abdominal muscles recorded simultaneously by ultrasound imaging and intramuscular electromyography. J Electromyogr Kinesiol 2009, 19(2):e23-e31.
16. Shojania KG, Sampson M, Ansari MT, Ji J, Doucette S, Moher D: How quickly do systematic reviews go out of date? A survival analysis. Ann Intern Med 2007, 147:224-233.
17. Macedo LG, Maher CG, Latimer J, McAuley JH: Motor control exercise for persistent, nonspecific low back pain: A systematic review. Phys Ther 2009, 89:9-25.
18. Hauggaard A, Persson AL: Specific spinal stabilisation exercises in patients with low back pain - A systematic review. Phys Ther Rev 2007, 12(3):233-248.
19. Ferreira PH, Ferreira ML, Maher CG, Herbert RD, Refshauge K: Specific stabilisation exercise for spinal and pelvic pain: A systematic review. Aust J Physiother 2006, 52:79-88.
20. Rackwitz B, de Bie R, Limm H, von Garnier K, Ewert T, Stucki G: Segmental stabilizing exercises and low back pain. What is the evidence? A systematic review of randomized controlled trials. Clin Rehabil 2006, 20:553-567.
21. Wang XQ, Zheng JJ, Yu ZW, Bi X, Lou SJ, Liu J, Cai B, Hua YH, Wu M, Wei ML, Shen HM, Chen Y, Pan YJ, Xu GH, Chen PJ, Eldabe S: A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One 2012, 7:e52082.
22. Byström MG, Rasmussen-Barr E, Grooten WJA: Motor control exercises reduces pain and disability in chronic and recurrent low back pain: A meta-analysis. Spine (Phila Pa 1976) 2013, 38:E350-8.
23. Moher D, Liberati A, Tetzlaff J, Altman DG: Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med 2009, 6(7):e1000097.
24. Norris C: Back Stability. Leeds: Human Kinetics Europe Ltd; 2000.
25. O'Sullivan PB, Phyty GD, Twomey LT, Allison GT: Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine (Phila Pa 1976) 1997, 22:2959-2967.
26. Cohen J: A coefficient of agreement of nominal scales. Educ Psychol Meas 1960, 20:37-46.
27. Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics 1977, 33:159-174.
28. Fleiss JL: Statistical Methods for Rates and Proportions. 2nd edition. New York: John Wiley; 1981.
29. Miyamoto GC, Costa LOP, Galvanin T, Cabral CMN: Efficacy of the addition of modified pilates exercises to a minimal intervention in patients with chronic low back pain: A randomized controlled trial. Phys Ther 2012, 93(3):310-320.
30. Mohseni-Bandpei MA, Rahmani N, Behtash H, Karimloo M: The effect of pelvic floor muscle exercise on women with chronic non-specific low back pain. J Bodyw Mov Ther 2011, 15:75-81.
31. Smith D, Bissell G, Bruce-Low S, Wakefield C: The effect of lumbar extension training with and without pelvic stabilization on lumbar strength and low back pain. J Back Musculoskelet Rehabil 2011, 24:241-249.
32. Wajswelner H, Metcalf B, Bennell K: Clinical pilates versus general exercise for chronic low back pain: randomized trial. Med Sci Sports Exerc 2012, 44:1197-205.
33. Sung PS: Disability and back muscle fatigability changes following two therapeutic exercise interventions in participants with recurrent low back pain. Med Sci Monit 2013, 19:40-8.
34. Babur MN, Ahmed D, Rashid F: Comparing the effectiveness of lumbar stabilization exercises with general spinal exercises in patients with postero-lateral disc herniation. Rawal Med J 2011, 36:259-261.
35. Kumar S, Sharma VP, Negi MPS: Efficacy of dynamic muscular stabilization techniques (DMST) over conventional techniques in rehabilitation of chronic low back pain. J Strength Cond Res 2009, 23:2651-2659.
36. Ferreira PH, Ferreira ML, Maher CG, Refshauge K, Herbert RD, Hodges PW: Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain. Br J Sports Med 2010, 44:1166-1172.
37. Kumar SP: Efficacy of segmental stabilization exercise for lumbar segmental instability in patients with mechanical low back pain: A randomized placebo controlled crossover study. N Am J Med Sci 2011, 3:456-461.
38. Norris C, Matthews M: The role of an integrated back stability program in patients with chronic low back pain. Complement Ther Clin Pract 2008, 14:255-63.
39. Stankovic A, Lazovic M, Kocic M, Dimitrijevic L, Stankovic I, Zlatanovic D, Dimitrijevic I: Lumbar stabilization exercises in addition to strengthening and stretching exercises reduce pain and increase function in patients with chronic low back pain: randomized clinical open-label study. Turkish J Phys Med Rehabil 2012, 58:177-183.
40. Vasseljen O, Fladmark AM: Abdominal muscle contraction thickness and function after specific and general exercises: A randomized controlled trial in chronic low back pain patients. Man Ther 2010, 15:482-489.
41. Vasseljen O, Unsgaard-Tondel M, Westad C, Mork PJ: Effect of core stability exercises on feed-forward activation of deep abdominal muscles in chronic low back pain: A randomized controlled trial [with consumer summary]. Spine (Phila Pa 1976) 2012, 37:1101-1108.
42. Higgins J, Deeks J: Cochrane Handbook: General Methods For Cochrane Reviews: Ch 7: Selecting Studies and Collecting Data. In Cochrane Handb Syst Rev Interv. Volume 6. Edited by Higgins PTJ, Green S. Wiley-Blackwell; 2011:151-186 [Cochrane Book Series].
43. Javadian Y, Behtash H, Akbari M, Taghipour-Darzi M, Zekavat H: The effects of stabilizing exercises on pain and disability of patients with lumbar segmental instability. J Back Musculoskelet Rehabil 2012, 25:149-155.
44. Rhee HS, Kim YH, Sung PS: A randomized controlled trial to determine the effect of spinal stabilization exercise intervention based on pain level and standing balance differences in patients with low back pain. Med Sci Monit 2012, 18:CR174-81.
45. Rasmussen-Barr E, Ang B, Arvidsson I, Nilsson-Wikmar L: Graded exercise for recurrent low-back pain: A randomized, controlled trial with 6-, 12-, and 36-month follow-ups. Spine (Phila Pa 1976) 2009, 34:221-228.
46. Furlan JC, Kalsi-Ryan S, Kailaya-Vasan A, Massicotte EM, Fehlings MG: Functional and clinical outcomes following surgical treatment in patients with cervical spondylotic myelopathy: A prospective study of 81 cases. J Neurosurg Spine 2011, 14:348-355.
47. Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M: Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 2003, 83:713-721.
48. Verhagen AP, De Vet HCW, De Bie RA, Kessels AGH, Boers M, Bouter LM, Knipschild PG: The Delphi list: A criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol 1998, 51:1235-1241.
49. Sherrington C, Herbert RD, Maher CG, Moseley AM: PEDro. A database of randomized trials and systematic reviews in physiotherapy. Man Ther 2000, 5:223-226.
50. PEDro. Physiotherapy Evidence Database. [http://www.pedro.org.au/].
51. Moseley AM, Herbert RD, Sherrington C, Maher CG: Evidence for physiotherapy practice: A survey of the Physiotherapy Evidence Database (PEDRO). Aust J Physiother 2002, 48:43-49.
52. Herbert RD: How to estimate treatment effects from reports of clinical trials. I: continuous outcomes. Aust J Physiother 2000, 46:229-235.
53. Wallace BC, Dahabreh IJ, Trikalinos TA, Lau J, Trow P, Schmid CH: Closing the gap between methodologists and end-users: R as a computational back-end. Wiley Interdiscip Rev Comput 2012, 49:1-15.
54. Higgins J, Thompson S, Deeks J, Altman D: Measuring inconsistency in meta-analyses. BMJ 2003, 327:557-60.
55. DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials 1986, 7:177-188.
56. Kluge J, Hall D, Louw Q, Theron G, Grové D: Specific exercises to treat pregnancy-related low back pain in a South African population. Int J Gynaecol Obstet 2011, 113:187-191.
57. Mannion AF, Denzler R, Dvorak J, Müntener M, Grob D: A randomised controlled trial of post-operative rehabilitation after surgical decompression of the lumbar spine. Eur Spine J 2007, 16:1101-1117.
58. Ammar TA, Mitchell K, Saleh A: Stabilization exercises in postnatal low back pain. Indian J Physiother Occup Ther 2011, 5(1):122-124.
59. Bi X, Zhao J, Zhao L, Liu Z, Zhang J, Sun D, Song L, Xia Y: Pelvic floor muscle exercise for chronic low back pain. J Int Med Res 2013, 41:146-152.
60. Gatti R, Faccendini S, Tettamanti A, Barbero M, Balestri A, Calori G: Efficacy of trunk balance exercises for individuals with chronic low back pain: A randomized clinical trial. J Orthop Sport Phys Ther 2011, 41(8):542-552.
61. Shnayderman I, Katz-Leurer M: An aerobic walking programme versus muscle strengthening programme for chronic low back pain: A randomized controlled trial. Clin Rehabil 2013, 27:207-214.
62. Unsgaard-Tøndel M, Lund Nilsen TI, Magnussen J, Vasseljen O: Is activation of transversus abdominis and obliquus internus abdominis associated with long-term changes in chronic low back pain? A prospective study with 1-year follow-up. Br J Sports Med 2012, 46:729-34.
63. Yoo Y-D, Lee Y-S: The effect of core stabilization exercises using a sling on pain and muscle strength of patients with chronic low back pain. J Phys Ther Sci 2012, 24:671.
64. Goel P, Veqar Z, Quddus N: Effects of local versus global stabilizer strengthening in chronic low back pain. Indian J Physiother Occup Ther 2010, 4:68-74.
65. Brooks C, Marshall PW, Kennedy S: Specific trunk and general exercise elicit similar changes in anticipatory postural adjustments in patients with chronic low back pain. Spine (Phila Pa 1976) 2012, 37(25):E1543-E1550.
66. Muthukrishnan R, Shenoy SD, Jaspal SS, Nellikunja S, Fernandes S: The differential effects of core stabilization exercise regime and conventional physiotherapy regime on postural control parameters during perturbation in patients with movement and control impairment chronic low back pain. Sports Med Arthrosc Rehabil Ther Technol 2010, 2:13.
67. Akbaria A, Khorashadizadeh S, Abdi G: The effect of motor control exercise versus general exercise on lumbar local stabilizing muscles thickness: randomized controlled trial of patients with chronic low back pain. J Back Musculoskelet Rehabil 2008, 21(2):105-112.
68. Costa LOP, Maher CG, Latimer J, Hodges PW, Herbert RD, Refshauge KM, McAuley JH, Jennings MD: Motor control exercise for chronic low back pain: A randomized placebo-controlled trial. Phys Ther 2009, 89:1275-1286.
69. Critchley DJ, Ratcliffe J, Noonan S, Jones RH, Hurley MV: Effectiveness and cost-effectiveness of three types of physiotherapy used to reduce chronic low back pain disability: A pragmatic randomized trial with economic evaluation. Spine (Phila Pa 1976) 2007, 32:1474-1481.
70. Ferreira ML, Ferreira PH, Latimer J, Herbert RD, Hodges PW, Jennings MD, Maher CG, Refshauge KM: Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial. Pain 2007, 131:31-37.
71. França FR, Burke TN, Hanada ES, Marques AP: Segmental stabilization and muscular strengthening in chronic low back pain: A comparative study. Clinics (Sao Paulo) 2010, 65:1013-1017.
72. França FR, Burke TN, Caffaro RR, Ramos LA, Marques AP: Effects of muscular stretching and segmental stabilization on functional disability and pain in patients with chronic low back pain: A randomized, controlled trial. J Manipulative Physiol Ther 2012, 35:279-285.
73. Gladwell V, Head S, Haggar M, Beneke R: Does a program of pilates improve chronic non-specific low back pain? J Sport Rehabil 2006, 15:338-350.
74. Inani SB, Selkar SP: Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: A randomized clinical trial. J Back Musculoskelet Rehabil 2013, 26:37-43.
75. Kumar S, Sharma VP, Shukla R, Dev R: Comparative efficacy of two multimodal treatments on male and female sub-groups with low back pain (part II). J Back Musculoskelet Rehabil 2010, 23:1-9.
76. Macedo LG, Latimer J, Maher CG, Hodges PW, McAuley JH, Nicholas MK, Tonkin L, Stanton CJ, Stanton TR, Stafford R: Effect of motor control exercises versus graded activity in patients with chronic nonspecific low back pain: A randomized controlled trial. Phys Ther 2012, 92:363-77.
77. Marshall PWM, Kennedy S, Brooks C, Lonsdale C: Pilates exercise or stationary cycling for chronic nonspecific low back pain: does it matter? a randomized controlled trial with 6-month follow-up. Spine (Phila Pa 1976) 2013, 38:E952-9.
78. Moon HJ, Choi KH, Kim DH, Kim HJ, Cho YK, Lee KH, Kim JH, Choi YJ: Effect of lumbar stabilization and dynamic lumbar strengthening exercises in patients with chronic low back pain. Ann Rehabil Med 2013, 37:110-7.
79. Unsgaard-Tøndel M, Fladmark AM, Salvesen Ø, Vasseljen O: Motor control exercises, sling exercises, and general exercises for patients with chronic low back pain: A randomized controlled trial with 1-year follow-up. Phys Ther 2010, 90:1426-1440.
80. Xueqiang W, Jiejiao Z, Xia B, Jing L: Effect of core stability training on patients with chronic low back pain. HealthMED 2012, 6:754-759.
81. Stuge B, Laerum E, Kirkesola G, Vøllestad N: The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: A randomized controlled trial. Spine (Phila Pa 1976) 2004, 29:351-359.
82. Bakhtiary AH, Safavi-Farokhi Z, Rezasoltani A: Lumbar stabilizing exercises improve activities of daily living in patients with lumbar disc herniation. J Back Musculoskelet Rehabil 2005, 18:55-60.
83. Filiz M, Cakmak A, Ozcan E: The effectiveness of exercise programmes after lumbar disc surgery: A randomized controlled study. Clin Rehabil 2005, 19:4-11.
84. Elden H, Ladfors L, Olsen MF, Ostgaard H-C, Hagberg H: Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial. BMJ 2005, 330:761.
85. Shaughnessy M, Caulfield B: A pilot study to investigate the effect of lumbar stabilisation exercise training on functional ability and quality of life in patients with chronic low back pain. Int J Rehabil Res 2004, 27:297-301.
86. Hides JA, Jull GA, Richardson CA: Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine (Phila Pa 1976) 2001, 26:E243-E248.
87. Goldby LJ, Moore AP, Doust J, Trew ME: A randomized controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder. Spine (Phila Pa 1976) 2006, 31:1083-1093.
88. Cairns MC, Foster NE, Wright C: Randomized controlled trial of specific spinal stabilization exercises and conventional physiotherapy for recurrent low back pain. Spine (Phila Pa 1976) 2006, 31:E670-E681.
89. Hides JA, Richardson CA, Jull GA: Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine (Phila Pa 1976) 1996, 21:2763-2769.
90. Moseley L: Combined physiotherapy and education is efficacious for chronic low back pain. Aust J Physiother 2002, 48:297-302.
91. Niemistö L, Lahtinen-Suopanki T, Rissanen, Lindgren K, Sarna S, Hurri H: A randomized trial of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain. Spine (Phila Pa 1976) 2003, 28:2185-91.
92. Rasmussen-Barr E, Nilsson-Wikmar L, Arvidsson I: Stabilizing training compared with manual treatment in sub-acute and chronic low-back pain. Man Ther 2003, 8:233-241.
93. Childs MJD, Fritz JM, Flynn TW, Irrgang JJ, Johnson MKK: Article a clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation : A validation study. Ann Intern Med 2004, 141:920-928.
94. Monticone M, Barbarino A, Testi C, Arzano S, Moschi A, Negrini S: Symptomatic efficacy of stabilizing treatment versus laser therapy for sub-acute low back pain with positive tests for sacroiliac dysfunction: A randomised clinical controlled trial with 1 year follow-up. Eura Medicophys 2004, 40:263-268.
95. Koumantakis GA, Watson PJ, Oldham JA: Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther 2005, 85:209-225.
96. Celestini M, Marchese A, Serenelli A, Graziani G: A randomized controlled trial on the efficacy of physical exercise in patients braced for instability of the lumbar spine. Eura Medicophys 2005, 41:223-231.
97. Miller ER, Schenk RJ, Karnes JL, Rousselle JG: A comparison of the McKenzie approach to a specific spine stabilization program for chronic low back pain. J Man Manip Ther 2005, 103-112.
98. Brennan GP, Fritz JM, Hunter SJ, Thackeray A, Delitto A, Erhard RE: Identifying subgroups of patients with acute/subacute "nonspecific" low back pain: results of a randomized clinical trial. Spine (Phila Pa 1976) 2006, 31:623-631.
99. Niemistö L, Rissanen P, Sarna S, Lahtinen-Suopanki T, Lindgren K-A, Hurri H: Cost-effectiveness of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain: A prospective randomized trial with 2-year follow-up. Spine (Phila Pa 1976) 2005, 30:1109-1115.
100. Maughan EF, Lewis JS: Outcome measures in chronic low back pain. Eur Spine J 2010, 19:1484-1494.
101. Nijs J, Roussel N, Paul van Wilgen C, Köke A, Smeets R: Thinking beyond muscles and joints: Therapists' and patients' attitudes and beliefs regarding chronic musculoskeletal pain are key to applying effective treatment. Man Ther 2013, 18:96-102.
102. Katz J: Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Jt Surg 2006, 88:21-24.
103. Lefebvre C, Manheimer E, Glanville J: Searching for studies. In Cochrane Handb Syst Rev Interv. Edited by Higgins J, Green S. Chichester: Wiley-Blackwell; 2008:95-150.
104. Van Driel ML, De Sutter A, De Maeseneer J, Christiaens T: Searching for unpublished trials in Cochrane reviews may not be worth the effort. J Clin Epidemiol 2009, 62(8):838-844.
105. Tekur P, Singphow C, Nagendra HR, Raghuram N: Effect of short-term intensive yoga program on pain, functional disability and spinal flexibility in chronic low back pain: A randomized control study. J Altern Complement Med 2008, 14:637-644.
106. Borenstein M, Hedges L, Higgins J, Rothstein H: Introduction to Meta-Analysis. 1st edition. New York: John Wiley & Sons, Ltd.; 2009.