Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review
Introduction The effect size for exercise therapy in the treatment of chronic non-specific low back pain (cLBP) is only modest. This review aims to analyse the specificity of the effect by examining the relationship between the changes in clinical outcome (pain, disability) and the changes in the ta...
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| Veröffentlicht in: | European spine journal 2012-04, Vol.21 (4), p.575-598 |
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| creator | Steiger, F. Wirth, B. de Bruin, E. D. Mannion, A. F. |
| description | Introduction
The effect size for exercise therapy in the treatment of chronic non-specific low back pain (cLBP) is only modest. This review aims to analyse the specificity of the effect by examining the relationship between the changes in clinical outcome (pain, disability) and the changes in the targeted aspects of physical function (muscle strength, mobility, muscular endurance) after exercise therapy.
Methods
We searched for exercise therapy trials for cLBP published up to 15 April 2010 in Medline, Embase, Cochrane Library, Cinahl, and PEDro. Two independent reviewers selected studies according to the inclusion criteria. Data extraction: one author extracted the data of the articles.
Results
Data synthesis: 16 studies with a total of 1,476 participants met the inclusion criteria. There was little evidence supporting a relationship between the changes in pain or physical function and the changes in performance for the following measures: mobility (no correlation in 9 studies, weak correlation in 1 study), trunk extension strength (7 and 2, respectively), trunk flexion strength (4 and 1, respectively) and back muscle endurance (7 and 0, respectively). Changes in disability showed no correlation with changes in mobility in three studies and a weak correlation in two; for strength, the numbers were four (no correlation) and two (weak correlation), respectively.
Conclusions
The findings do not support the notion that the treatment effects of exercise therapy in cLBP are directly attributable to changes in the musculoskeletal system. Future research aimed at increasing the effectiveness of exercise therapy in cLBP should explore the coincidental factors influencing symptom improvement. |
| doi_str_mv | 10.1007/s00586-011-2045-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3326132</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1017980710</sourcerecordid><originalsourceid>FETCH-LOGICAL-c569t-67a219fdc106b53c5c0f8ac97d5991b0f03517f7bbabe7b94a507e17577677ee3</originalsourceid><addsrcrecordid>eNqNks1u1DAQgCMEokvhAbggS1zKITB2Ynt9AVUVP5UqcYGz5Xgnuy6JHWxny74gz4WjLVVBQuLkn_n8zdieqnpO4TUFkG8SAF-LGiitGbS8Fg-qFW0bVoNq2MNqBaqFWkiqTqonKV0DUK5APK5OGAPJCrSqfl4mYsgUkstuj8QOzjtrBhLmbMOIxPQZI8EfGK1LSPIOo5kOpA-R2F0MBSY--DpNaF1fFkO4IZ2x38hknCc2-Oz8Fn0m8xR8yWRDjJjKfFP2iRunGPY4LkDBi51kE7eYcUPM4sxn6RUJPZkwlpSj8RbfkXOSDinjaHJJGHHv8OZp9ag3Q8Jnt-Np9fXD-y8Xn-qrzx8vL86vasuFyuUtDKOq31gKouON5Rb6tbFKbrhStIMeGk5lL7vOdCg71RoOEqnkUgopEZvT6u3RO83diBtbCo9m0FN0o4kHHYzTf0a82-lt2OumYYI2rAjObgUxfJ8xZT26ZHEYjMcwJ02BSrUGSeE_UFCcFa8o6Mu_0OswR19eYhEyKda0bQtFj5SNIaWI_V3dFBab1MeG0qWh9NJQejG_uH_huxO_O6gA7AikEipfHe-n_pf1F_rg2us</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1012768144</pqid></control><display><type>article</type><title>Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Steiger, F. ; Wirth, B. ; de Bruin, E. D. ; Mannion, A. F.</creator><creatorcontrib>Steiger, F. ; Wirth, B. ; de Bruin, E. D. ; Mannion, A. F.</creatorcontrib><description>Introduction
The effect size for exercise therapy in the treatment of chronic non-specific low back pain (cLBP) is only modest. This review aims to analyse the specificity of the effect by examining the relationship between the changes in clinical outcome (pain, disability) and the changes in the targeted aspects of physical function (muscle strength, mobility, muscular endurance) after exercise therapy.
Methods
We searched for exercise therapy trials for cLBP published up to 15 April 2010 in Medline, Embase, Cochrane Library, Cinahl, and PEDro. Two independent reviewers selected studies according to the inclusion criteria. Data extraction: one author extracted the data of the articles.
Results
Data synthesis: 16 studies with a total of 1,476 participants met the inclusion criteria. There was little evidence supporting a relationship between the changes in pain or physical function and the changes in performance for the following measures: mobility (no correlation in 9 studies, weak correlation in 1 study), trunk extension strength (7 and 2, respectively), trunk flexion strength (4 and 1, respectively) and back muscle endurance (7 and 0, respectively). Changes in disability showed no correlation with changes in mobility in three studies and a weak correlation in two; for strength, the numbers were four (no correlation) and two (weak correlation), respectively.
Conclusions
The findings do not support the notion that the treatment effects of exercise therapy in cLBP are directly attributable to changes in the musculoskeletal system. Future research aimed at increasing the effectiveness of exercise therapy in cLBP should explore the coincidental factors influencing symptom improvement.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-011-2045-6</identifier><identifier>PMID: 22072093</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Disability Evaluation ; Exercise Therapy ; Humans ; Low Back Pain - physiopathology ; Low Back Pain - therapy ; Medicine ; Medicine & Public Health ; Muscle Strength - physiology ; Musculoskeletal System - physiopathology ; Neurosurgery ; Physical Endurance - physiology ; Review ; Review Article ; Surgical Orthopedics ; Surveys and Questionnaires ; Treatment Outcome</subject><ispartof>European spine journal, 2012-04, Vol.21 (4), p.575-598</ispartof><rights>Springer-Verlag 2011</rights><rights>Springer-Verlag 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c569t-67a219fdc106b53c5c0f8ac97d5991b0f03517f7bbabe7b94a507e17577677ee3</citedby><cites>FETCH-LOGICAL-c569t-67a219fdc106b53c5c0f8ac97d5991b0f03517f7bbabe7b94a507e17577677ee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3326132/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3326132/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22072093$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Steiger, F.</creatorcontrib><creatorcontrib>Wirth, B.</creatorcontrib><creatorcontrib>de Bruin, E. D.</creatorcontrib><creatorcontrib>Mannion, A. F.</creatorcontrib><title>Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Introduction
The effect size for exercise therapy in the treatment of chronic non-specific low back pain (cLBP) is only modest. This review aims to analyse the specificity of the effect by examining the relationship between the changes in clinical outcome (pain, disability) and the changes in the targeted aspects of physical function (muscle strength, mobility, muscular endurance) after exercise therapy.
Methods
We searched for exercise therapy trials for cLBP published up to 15 April 2010 in Medline, Embase, Cochrane Library, Cinahl, and PEDro. Two independent reviewers selected studies according to the inclusion criteria. Data extraction: one author extracted the data of the articles.
Results
Data synthesis: 16 studies with a total of 1,476 participants met the inclusion criteria. There was little evidence supporting a relationship between the changes in pain or physical function and the changes in performance for the following measures: mobility (no correlation in 9 studies, weak correlation in 1 study), trunk extension strength (7 and 2, respectively), trunk flexion strength (4 and 1, respectively) and back muscle endurance (7 and 0, respectively). Changes in disability showed no correlation with changes in mobility in three studies and a weak correlation in two; for strength, the numbers were four (no correlation) and two (weak correlation), respectively.
Conclusions
The findings do not support the notion that the treatment effects of exercise therapy in cLBP are directly attributable to changes in the musculoskeletal system. Future research aimed at increasing the effectiveness of exercise therapy in cLBP should explore the coincidental factors influencing symptom improvement.</description><subject>Disability Evaluation</subject><subject>Exercise Therapy</subject><subject>Humans</subject><subject>Low Back Pain - physiopathology</subject><subject>Low Back Pain - therapy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Muscle Strength - physiology</subject><subject>Musculoskeletal System - physiopathology</subject><subject>Neurosurgery</subject><subject>Physical Endurance - physiology</subject><subject>Review</subject><subject>Review Article</subject><subject>Surgical Orthopedics</subject><subject>Surveys and Questionnaires</subject><subject>Treatment Outcome</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNks1u1DAQgCMEokvhAbggS1zKITB2Ynt9AVUVP5UqcYGz5Xgnuy6JHWxny74gz4WjLVVBQuLkn_n8zdieqnpO4TUFkG8SAF-LGiitGbS8Fg-qFW0bVoNq2MNqBaqFWkiqTqonKV0DUK5APK5OGAPJCrSqfl4mYsgUkstuj8QOzjtrBhLmbMOIxPQZI8EfGK1LSPIOo5kOpA-R2F0MBSY--DpNaF1fFkO4IZ2x38hknCc2-Oz8Fn0m8xR8yWRDjJjKfFP2iRunGPY4LkDBi51kE7eYcUPM4sxn6RUJPZkwlpSj8RbfkXOSDinjaHJJGHHv8OZp9ag3Q8Jnt-Np9fXD-y8Xn-qrzx8vL86vasuFyuUtDKOq31gKouON5Rb6tbFKbrhStIMeGk5lL7vOdCg71RoOEqnkUgopEZvT6u3RO83diBtbCo9m0FN0o4kHHYzTf0a82-lt2OumYYI2rAjObgUxfJ8xZT26ZHEYjMcwJ02BSrUGSeE_UFCcFa8o6Mu_0OswR19eYhEyKda0bQtFj5SNIaWI_V3dFBab1MeG0qWh9NJQejG_uH_huxO_O6gA7AikEipfHe-n_pf1F_rg2us</recordid><startdate>20120401</startdate><enddate>20120401</enddate><creator>Steiger, F.</creator><creator>Wirth, B.</creator><creator>de Bruin, E. D.</creator><creator>Mannion, A. F.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</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>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7TS</scope><scope>5PM</scope></search><sort><creationdate>20120401</creationdate><title>Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review</title><author>Steiger, F. ; Wirth, B. ; de Bruin, E. D. ; Mannion, A. F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c569t-67a219fdc106b53c5c0f8ac97d5991b0f03517f7bbabe7b94a507e17577677ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Disability Evaluation</topic><topic>Exercise Therapy</topic><topic>Humans</topic><topic>Low Back Pain - physiopathology</topic><topic>Low Back Pain - therapy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Muscle Strength - physiology</topic><topic>Musculoskeletal System - physiopathology</topic><topic>Neurosurgery</topic><topic>Physical Endurance - physiology</topic><topic>Review</topic><topic>Review Article</topic><topic>Surgical Orthopedics</topic><topic>Surveys and Questionnaires</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Steiger, F.</creatorcontrib><creatorcontrib>Wirth, B.</creatorcontrib><creatorcontrib>de Bruin, E. D.</creatorcontrib><creatorcontrib>Mannion, A. F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Physical Education Index</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Steiger, F.</au><au>Wirth, B.</au><au>de Bruin, E. D.</au><au>Mannion, A. F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2012-04-01</date><risdate>2012</risdate><volume>21</volume><issue>4</issue><spage>575</spage><epage>598</epage><pages>575-598</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Introduction
The effect size for exercise therapy in the treatment of chronic non-specific low back pain (cLBP) is only modest. This review aims to analyse the specificity of the effect by examining the relationship between the changes in clinical outcome (pain, disability) and the changes in the targeted aspects of physical function (muscle strength, mobility, muscular endurance) after exercise therapy.
Methods
We searched for exercise therapy trials for cLBP published up to 15 April 2010 in Medline, Embase, Cochrane Library, Cinahl, and PEDro. Two independent reviewers selected studies according to the inclusion criteria. Data extraction: one author extracted the data of the articles.
Results
Data synthesis: 16 studies with a total of 1,476 participants met the inclusion criteria. There was little evidence supporting a relationship between the changes in pain or physical function and the changes in performance for the following measures: mobility (no correlation in 9 studies, weak correlation in 1 study), trunk extension strength (7 and 2, respectively), trunk flexion strength (4 and 1, respectively) and back muscle endurance (7 and 0, respectively). Changes in disability showed no correlation with changes in mobility in three studies and a weak correlation in two; for strength, the numbers were four (no correlation) and two (weak correlation), respectively.
Conclusions
The findings do not support the notion that the treatment effects of exercise therapy in cLBP are directly attributable to changes in the musculoskeletal system. Future research aimed at increasing the effectiveness of exercise therapy in cLBP should explore the coincidental factors influencing symptom improvement.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22072093</pmid><doi>10.1007/s00586-011-2045-6</doi><tpages>24</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | European spine journal, 2012-04, Vol.21 (4), p.575-598 |
| issn | 0940-6719 1432-0932 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Disability Evaluation Exercise Therapy Humans Low Back Pain - physiopathology Low Back Pain - therapy Medicine Medicine & Public Health Muscle Strength - physiology Musculoskeletal System - physiopathology Neurosurgery Physical Endurance - physiology Review Review Article Surgical Orthopedics Surveys and Questionnaires Treatment Outcome |
| title | Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review |
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