The association of physical deconditioning and chronic low back pain: A hypothesis-oriented systematic review
Purpose. Does physical deconditioning (loss of cardiovascular capacity and strength endurance of paraspinal muscles) exist in patients with chronic low back pain (CLBP) and are treatments specifically aimed to reduce these signs effective? Method. Systematic literature search in PUBMED, MEDLINE, EMB...
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| Veröffentlicht in: | Disability and rehabilitation 2006-06, Vol.28 (11), p.673-693 |
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| container_title | Disability and rehabilitation |
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| creator | Smeets, Rob J. E. M. Wade, Derick Hidding, Alita Van Leeuwen, Peter J. C. M. Vlaeyen, Johan W. S. Knottnerus, J. Andre |
| description | Purpose. Does physical deconditioning (loss of cardiovascular capacity and strength endurance of paraspinal muscles) exist in patients with chronic low back pain (CLBP) and are treatments specifically aimed to reduce these signs effective?
Method. Systematic literature search in PUBMED, MEDLINE, EMBASE and PsycINFO until December 2004 to identify observational studies regarding deconditioning signs and high quality RCTs regarding the effectiveness of cardiovascular and or muscle strengthening exercises. Internal validity of the RCTs was assessed by using a checklist of nine methodology criteria in accordance with the Cochrane Collaboration.
Results. There is conflicting evidence that cardiovascular deconditioning is present in CLBP and limited evidence for wasting of the multifidus muscle. No study examined the effectiveness of cardiovascular training specifically. General and lumbar muscle strengthening are equally effective as other active treatments. Only moderate evidence is available for the effectiveness of intensive low back extensor muscle strengthening compared to less intensive strengthening.
Conclusion. Probably reactivation caused by active treatment and not the reconditioning itself is the important factor in the reduction of disability. Further prospective and evaluative research into the role of physical deconditioning is necessary. It seems more promising to further explore the interplay between biological, social and psychological factors. |
| doi_str_mv | 10.1080/09638280500264782 |
| format | Article |
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Method. Systematic literature search in PUBMED, MEDLINE, EMBASE and PsycINFO until December 2004 to identify observational studies regarding deconditioning signs and high quality RCTs regarding the effectiveness of cardiovascular and or muscle strengthening exercises. Internal validity of the RCTs was assessed by using a checklist of nine methodology criteria in accordance with the Cochrane Collaboration.
Results. There is conflicting evidence that cardiovascular deconditioning is present in CLBP and limited evidence for wasting of the multifidus muscle. No study examined the effectiveness of cardiovascular training specifically. General and lumbar muscle strengthening are equally effective as other active treatments. Only moderate evidence is available for the effectiveness of intensive low back extensor muscle strengthening compared to less intensive strengthening.
Conclusion. Probably reactivation caused by active treatment and not the reconditioning itself is the important factor in the reduction of disability. Further prospective and evaluative research into the role of physical deconditioning is necessary. It seems more promising to further explore the interplay between biological, social and psychological factors.</description><identifier>ISSN: 0963-8288</identifier><identifier>EISSN: 1464-5165</identifier><identifier>DOI: 10.1080/09638280500264782</identifier><identifier>PMID: 16809211</identifier><language>eng</language><publisher>England: Informa UK Ltd</publisher><subject>cardiovascular deconditioning ; Cardiovascular Deconditioning - physiology ; Chronic Disease ; clinical trials ; exercise ; Humans ; low back pain ; Low Back Pain - physiopathology ; Low Back Pain - rehabilitation ; muscle atrophy ; muscle fibers ; Muscle, Skeletal - physiopathology ; Physical Endurance - physiology ; physical fitness ; Physical Fitness - physiology ; rehabilitation ; Review literature ; systematic review ; Treatment Outcome</subject><ispartof>Disability and rehabilitation, 2006-06, Vol.28 (11), p.673-693</ispartof><rights>2006 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-cd5c1a58ef0c081cdfe309fd51b82f45bdfb30d6c334873e72101fe5f785bd7b3</citedby><cites>FETCH-LOGICAL-c435t-cd5c1a58ef0c081cdfe309fd51b82f45bdfb30d6c334873e72101fe5f785bd7b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/09638280500264782$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/09638280500264782$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,59652,59758,60441,60547,61226,61261,61407,61442</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16809211$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smeets, Rob J. E. M.</creatorcontrib><creatorcontrib>Wade, Derick</creatorcontrib><creatorcontrib>Hidding, Alita</creatorcontrib><creatorcontrib>Van Leeuwen, Peter J. C. M.</creatorcontrib><creatorcontrib>Vlaeyen, Johan W. S.</creatorcontrib><creatorcontrib>Knottnerus, J. Andre</creatorcontrib><title>The association of physical deconditioning and chronic low back pain: A hypothesis-oriented systematic review</title><title>Disability and rehabilitation</title><addtitle>Disabil Rehabil</addtitle><description>Purpose. Does physical deconditioning (loss of cardiovascular capacity and strength endurance of paraspinal muscles) exist in patients with chronic low back pain (CLBP) and are treatments specifically aimed to reduce these signs effective?
Method. Systematic literature search in PUBMED, MEDLINE, EMBASE and PsycINFO until December 2004 to identify observational studies regarding deconditioning signs and high quality RCTs regarding the effectiveness of cardiovascular and or muscle strengthening exercises. Internal validity of the RCTs was assessed by using a checklist of nine methodology criteria in accordance with the Cochrane Collaboration.
Results. There is conflicting evidence that cardiovascular deconditioning is present in CLBP and limited evidence for wasting of the multifidus muscle. No study examined the effectiveness of cardiovascular training specifically. General and lumbar muscle strengthening are equally effective as other active treatments. Only moderate evidence is available for the effectiveness of intensive low back extensor muscle strengthening compared to less intensive strengthening.
Conclusion. Probably reactivation caused by active treatment and not the reconditioning itself is the important factor in the reduction of disability. Further prospective and evaluative research into the role of physical deconditioning is necessary. It seems more promising to further explore the interplay between biological, social and psychological factors.</description><subject>cardiovascular deconditioning</subject><subject>Cardiovascular Deconditioning - physiology</subject><subject>Chronic Disease</subject><subject>clinical trials</subject><subject>exercise</subject><subject>Humans</subject><subject>low back pain</subject><subject>Low Back Pain - physiopathology</subject><subject>Low Back Pain - rehabilitation</subject><subject>muscle atrophy</subject><subject>muscle fibers</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Physical Endurance - physiology</subject><subject>physical fitness</subject><subject>Physical Fitness - physiology</subject><subject>rehabilitation</subject><subject>Review literature</subject><subject>systematic review</subject><subject>Treatment Outcome</subject><issn>0963-8288</issn><issn>1464-5165</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU9r3DAQxUVJaTZpP0AvRafcnIwsy5abXELoPwj0kp6FLI1qpbbkSt4s_vb1sgulFJLTMPN-7zHMEPKewSUDCVfQ1lyWEgRAWVeNLF-RDavqqhCsFidks9eLFZCn5CznRwBgvKnekFNWS2hLxjZkfOiR6pyj8Xr2MdDo6NQv2Rs9UIsmBuv3cx9-Uh0sNX1aG0OHuKOdNr_opH34SG9pv0xx7jH7XMTkMcxoaV7yjOOaa2jCJ4-7t-S100PGd8d6Tn58_vRw97W4__7l293tfWEqLubCWGGYFhIdGJDMWIccWmcF62TpKtFZ13GwteG8kg3HpmTAHArXyFVrOn5OLg65U4q_t5hnNfpscBh0wLjNqpaiLUGWL4KsrZnkDawgO4AmxZwTOjUlP-q0KAZq_wz13zNWz4dj-LYb0f51HK-_AjcHwAcX06h3MQ1WzXoZYnJJB-Oz4s_lX_9j71EPc290QvUYtymsF35muz-ko6vh</recordid><startdate>20060601</startdate><enddate>20060601</enddate><creator>Smeets, Rob J. E. M.</creator><creator>Wade, Derick</creator><creator>Hidding, Alita</creator><creator>Van Leeuwen, Peter J. C. M.</creator><creator>Vlaeyen, Johan W. S.</creator><creator>Knottnerus, J. Andre</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>20060601</creationdate><title>The association of physical deconditioning and chronic low back pain: A hypothesis-oriented systematic review</title><author>Smeets, Rob J. E. M. ; Wade, Derick ; Hidding, Alita ; Van Leeuwen, Peter J. C. M. ; Vlaeyen, Johan W. S. ; Knottnerus, J. Andre</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c435t-cd5c1a58ef0c081cdfe309fd51b82f45bdfb30d6c334873e72101fe5f785bd7b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>cardiovascular deconditioning</topic><topic>Cardiovascular Deconditioning - physiology</topic><topic>Chronic Disease</topic><topic>clinical trials</topic><topic>exercise</topic><topic>Humans</topic><topic>low back pain</topic><topic>Low Back Pain - physiopathology</topic><topic>Low Back Pain - rehabilitation</topic><topic>muscle atrophy</topic><topic>muscle fibers</topic><topic>Muscle, Skeletal - physiopathology</topic><topic>Physical Endurance - physiology</topic><topic>physical fitness</topic><topic>Physical Fitness - physiology</topic><topic>rehabilitation</topic><topic>Review literature</topic><topic>systematic review</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smeets, Rob J. E. M.</creatorcontrib><creatorcontrib>Wade, Derick</creatorcontrib><creatorcontrib>Hidding, Alita</creatorcontrib><creatorcontrib>Van Leeuwen, Peter J. C. M.</creatorcontrib><creatorcontrib>Vlaeyen, Johan W. S.</creatorcontrib><creatorcontrib>Knottnerus, J. Andre</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>Disability and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smeets, Rob J. E. M.</au><au>Wade, Derick</au><au>Hidding, Alita</au><au>Van Leeuwen, Peter J. C. M.</au><au>Vlaeyen, Johan W. S.</au><au>Knottnerus, J. Andre</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The association of physical deconditioning and chronic low back pain: A hypothesis-oriented systematic review</atitle><jtitle>Disability and rehabilitation</jtitle><addtitle>Disabil Rehabil</addtitle><date>2006-06-01</date><risdate>2006</risdate><volume>28</volume><issue>11</issue><spage>673</spage><epage>693</epage><pages>673-693</pages><issn>0963-8288</issn><eissn>1464-5165</eissn><abstract>Purpose. Does physical deconditioning (loss of cardiovascular capacity and strength endurance of paraspinal muscles) exist in patients with chronic low back pain (CLBP) and are treatments specifically aimed to reduce these signs effective?
Method. Systematic literature search in PUBMED, MEDLINE, EMBASE and PsycINFO until December 2004 to identify observational studies regarding deconditioning signs and high quality RCTs regarding the effectiveness of cardiovascular and or muscle strengthening exercises. Internal validity of the RCTs was assessed by using a checklist of nine methodology criteria in accordance with the Cochrane Collaboration.
Results. There is conflicting evidence that cardiovascular deconditioning is present in CLBP and limited evidence for wasting of the multifidus muscle. No study examined the effectiveness of cardiovascular training specifically. General and lumbar muscle strengthening are equally effective as other active treatments. Only moderate evidence is available for the effectiveness of intensive low back extensor muscle strengthening compared to less intensive strengthening.
Conclusion. Probably reactivation caused by active treatment and not the reconditioning itself is the important factor in the reduction of disability. Further prospective and evaluative research into the role of physical deconditioning is necessary. It seems more promising to further explore the interplay between biological, social and psychological factors.</abstract><cop>England</cop><pub>Informa UK Ltd</pub><pmid>16809211</pmid><doi>10.1080/09638280500264782</doi><tpages>21</tpages></addata></record> |
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| source | MEDLINE; Taylor & Francis Medical Library - CRKN; Access via Taylor & Francis |
| subjects | cardiovascular deconditioning Cardiovascular Deconditioning - physiology Chronic Disease clinical trials exercise Humans low back pain Low Back Pain - physiopathology Low Back Pain - rehabilitation muscle atrophy muscle fibers Muscle, Skeletal - physiopathology Physical Endurance - physiology physical fitness Physical Fitness - physiology rehabilitation Review literature systematic review Treatment Outcome |
| title | The association of physical deconditioning and chronic low back pain: A hypothesis-oriented systematic review |
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