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Trunk Muscle Stabilization Training Plus General Exercise Versus General Exercise Only: Randomized Controlled Trial of Patients With Recurrent Low Back Pain

GA Koumantakis, PT, PhD, MCSP, is Lecturer, School of Physical Therapy, Athens, Greece, and Private Practitioner, Drosopoulou 6, Kypseli, Athens, 112 57, Greece (gak4{at}otenet.gr)
PJ Watson, PT, PhD, MCSP, is Senior Lecturer, Division of Anaesthesia and Pain Management, University of Leicester, Leicester, Leicestershire, United Kingdom
JA Oldham, PhD, is Professor, Centre for Rehabilitation Science, University of Manchester, Manchester, Cheshire, United Kingdom

Address all correspondence to Dr Koumantakis

Background and Purpose. The purpose of this randomized controlled trial was to examine the usefulness of the addition of specific stabilization exercises to a general back and abdominal muscle exercise approach for patients with subacute or chronic nonspecific back pain by comparing a specific muscle stabilization–enhanced general exercise approach with a general exercise–only approach. Subjects. Fifty-five patients with recurrent, nonspecific back pain (stabilization–enhanced exercise group: n=29, general exercise–only group: n=26) and no clinical signs suggesting spinal instability were recruited. Methods. Both groups received an 8-week exercise intervention and written advice (The Back Book). Outcome was based on self-reported pain (Short-Form McGill Pain Questionnaire), disability (Roland-Morris Disability Questionnaire), and cognitive status (Pain Self-Efficacy Questionnaire, Tampa Scale of Kinesiophobia, Pain Locus of Control Scale) measured immediately before and after intervention and 3 months after the end of the intervention period. Results. Outcome measures for both groups improved. Furthermore, self-reported disability improved more in the general exercise–only group immediately after intervention but not at the 3-month follow-up. There were generally no differences between the 2 exercise approaches for any of the other outcomes. Discussion and Conclusion. A general exercise program reduced disability in the short term to a greater extent than a stabilization-enhanced exercise approach in patients with recurrent nonspecific low back pain. Stabilization exercises do not appear to provide additional benefit to patients with subacute or chronic low back pain who have no clinical signs suggesting the presence of spinal instability.

Key Words: Exercise • Low back pain • Randomized controlled trial • Rehabilitation • Stabilization

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