A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: Short-term results of a randomised controlled trial

BACKGROUND: Exercise is an effective treatment for patients with sub-acute and chronic low back pain (LBP). Patients with a movement control impairment (MCI) can be diagnosed as a subgroup of patients with LBP. Unknown is which exercise intervention is most beneficial for this subgroup. This study assessed the short-term effect of a specific exercise program targeting movement control impairment versus general exercise treatment on disability in patients with LBP and MCI.

METHODS: In a multicentre parallel group randomised controlled pragmatic trial, patients with sub-acute and chronic LBP were included. Further inclusion criteria were disability of ≥5 points on the Roland-Morris Disability Questionnaire and ≥2 positive tests out of a set of 6 movement control impairment tests. A total of 106 patients were randomly assigned to either tailored movement control exercise intervention (MC, n = 52) or a general exercise intervention (GE, n = 54); both 9-18 individual treatment sessions, over a maximum of 12 weeks. The primary outcome was disability measured with the Patient Specific Functional scale (PSFS). Secondary outcome was the Roland-Morris disability scale (RMDQ). Measurements were taken pre- and posttreatment.

RESULTS: No significant difference was found following the treatment period. Baseline-adjusted between-group mean difference for the PSFS was 0.5 (SD = 0.5; p = 0.32) in favour of MC exercises. The Roland-Morris Disability Questionnaire revealed a significant, but not clinically relevant, between-group difference of 2.0 points (SD = 0.8; p = 0.01).

CONCLUSION: Disability in LBP patients was reduced considerably by both interventions. However, the limited contrast between the two exercise programs may have influenced outcomes.