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European Journal of Physical and Rehabilitation Medicine 2021 May 07

DOI: 10.23736/S1973-9087.21.06555-2


language: English

Effectiveness of motor control exercise on non-specific chronic low back pain, disability and core muscle morphological characteristics: A meta-analysis of randomized controlled trials

Chanjuan ZHANG 1, Yuelong LI 1, Yuhua ZHONG 2, Chenyang FENG 3, Zhou ZHANG 1, Chuhuai WANG 1

1 Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 2 Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China; 3 Department of Medical Statistics and Epidemiology, School of Public Health, Sun -Sen University, Guangzhou, China

INTRODUCTION: Chronic low back pain (CLBP) has been recognized as the leading cause of disability. Up to 90% of patients with CLBP are classified as having non-specific CLBP (NSCLBP). Motor control exercise (MCE) is one of the most popular and widespread treatment options, and has many advantages in alleviating pain and disability. This meta-analysis is aimed to investigate the effectiveness of MCE on NSCLBP, disability, and core muscles reported in randomized controlled trials (RCTs).
METHODS: PubMed, Web of Science, and EMBASE were searched from inception to August 2020. Articles were eligible if they were RCTs that evaluated MCE against sham or other treatments in isolation and measured outcomes including pain intensity and disability or core muscles morphologic characteristics.
RESULTS: Two authors independently extracted the data. Eighteen studies of 897 studies with a total of 1333 individuals with NSCLBP were retained for the meta-analysis. Compared with other conservative treatments, MCE was better in reducing pain and disability posttreatment and was better in reducing pain at the 6-month follow-up period. However, it had comparable effects on pain reduction at 12-month and 24-month follow-up period, and on disability at the 6-month, 12-month and 24-month follow-up period. MCE resulted in comparable effects to other treatments in improving the core muscle thickness posttreatment. However, other important outcomes, such as the function, strength and endurance of core muscles, which could hamper a comprehensive understanding of the effects of MCE on NSCLBP.
LIMITATIONS: Publication bias was not assessed in several comparisons due to the scarcity of data in published literature. This might downgrade the strength of the evidence. The protocol of this meta-analysis was reviewed by an expert committee, but was not registered in a public trial registry.
CONCLUSIONS: Low to very low quality of evidence supported that MCE resulted in a greater reduction of pain and disability posttreatment, and a greater reduction of pain at the 6-month follow-up than other treatments for NSCBLP. The findings in this review further support that MCE may be more effective than other treatments at short-term followups, and at least has equivalent long-term effects to other forms of treatments in NSCLBP.

KEY WORDS: Chronic low back pain; Motor control exercise; Randomized controlled trials; Meta-analysis

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