The effect of motor control exercise versus general exercise on lumbar local stabilizing muscles thickness: Randomized controlled trial of patients with chronic low back pain
Affiliations: [a] Department of Physiotherapy, Faculty of Paramedicine, Zahedan University of Medical Sciences, Zahedan, Iran | [b] Department of Radiology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
Correspondence:
[*]
Address for correspondence: Dr. Asghar Akbari, Department of Physiotherapy, Razmejo-Moghadam Laboratory, Ayatoallah Kafami St, 98136-64855, Zahedan, Iran. Tel.: +98 541 325 4207; Fax: +98 541 325 4207; E-mail: akbari_as@yahoo.com/akbaria@zdmu.ac.ir
Abstract: Background:The specific training of lumbar local stabilizing muscles is one of the recent focuses in management of patients with chronic LBP. Enhanced stability of the lumbar spine segments is the mechanism for pain relief with this specific exercise. Objective:The aim of this study was to compare the effect of motor control exercises with general exercises on the lumbar local stabilizing muscles thickness, activity limitation and pain in patients with chronic low back pain (LBP). Design:A double-blind, randomized controlled trial. Methods:Forty-nine patients with chronic LBP were randomly assigned to either a motor control (n = 25) or a general exercises group (n = 24). Before and after intervention, we assessed the lumbar multifidus (LM) and Transversus abdominis (TA) muscles thickness (mm) using a 7.5 MHz B-mode transducer ultrasound, pain through visual analog scale and activity limitation through Back Performance Scale (Ordinal). A 16 session’s exercise program which lasted 8 weeks, twice per week, and 30 minutes per session was performed for both groups. Results:The mean TA thickness increased from 1.87 ± 0.63 mm to 2.39 ± 0.63 mm in the motor control group and from 1.93 ± 0.49 mm to 2.22 ± 0.47 mm in the general exercise group (P < 0.0001). The mean LM thickness increased from 8.63 ± 2.37 mm to 9.69 ± 2.49 mm in the motor control group and from 8.83 ± 1.53 mm to 9.26 ± 1.56 mm in the general exercise group (P < 0.0001). The mean activity limitation decreased from 8.83 ± 3.38 to 5.42 ± 2.43 in the motor control group and from 10.67 ± 2.81 to 7.25 ± 2.73 in the general exercise group (P < 0.0001). After treatment, there was no significant difference between two groups, with the exception of pain (P > 0.05). Conclusion:The motor control and general exercises decreased pain and increased TA and LM muscles thickness and lumbar mobility in patients with chronic LBP without any signs of spinal instability. Although, the motor control exercises were more effective than general exercises in pain decreasing.
Keywords: Low back pain, motor control exercise, general exercise, ultrasonography, lumbar multifidus, transversus abdominis, activity limitations, randomized controlled trial
