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Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects

Low-to-moderate quality meta-analytic evidence shows that motor control stabilisation exercise (MCE) is an effective treatment of non-specific low back pain. A possible approach to overcome the weaknesses of traditional meta-analyses would be that of a prospective meta-analyses. The aim of the prese...

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Autores principales: Niederer, Daniel, Engel, Tilman, Vogt, Lutz, Arampatzis, Adamantios, Banzer, Winfried, Beck, Heidrun, Moreno Catalá, María, Brenner-Fliesser, Michael, Güthoff, Claas, Haag, Thore, Hönning, Alexander, Pfeifer, Ann-Christin, Platen, Petra, Schiltenwolf, Marcus, Schneider, Christian, Trompeter, Katharina, Wippert, Pia-Maria, Mayer, Frank
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564352/
https://www.ncbi.nlm.nih.gov/pubmed/32971921
http://dx.doi.org/10.3390/jcm9093058
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author Niederer, Daniel
Engel, Tilman
Vogt, Lutz
Arampatzis, Adamantios
Banzer, Winfried
Beck, Heidrun
Moreno Catalá, María
Brenner-Fliesser, Michael
Güthoff, Claas
Haag, Thore
Hönning, Alexander
Pfeifer, Ann-Christin
Platen, Petra
Schiltenwolf, Marcus
Schneider, Christian
Trompeter, Katharina
Wippert, Pia-Maria
Mayer, Frank
author_facet Niederer, Daniel
Engel, Tilman
Vogt, Lutz
Arampatzis, Adamantios
Banzer, Winfried
Beck, Heidrun
Moreno Catalá, María
Brenner-Fliesser, Michael
Güthoff, Claas
Haag, Thore
Hönning, Alexander
Pfeifer, Ann-Christin
Platen, Petra
Schiltenwolf, Marcus
Schneider, Christian
Trompeter, Katharina
Wippert, Pia-Maria
Mayer, Frank
author_sort Niederer, Daniel
collection PubMed
description Low-to-moderate quality meta-analytic evidence shows that motor control stabilisation exercise (MCE) is an effective treatment of non-specific low back pain. A possible approach to overcome the weaknesses of traditional meta-analyses would be that of a prospective meta-analyses. The aim of the present analysis was to generate high-quality evidence to support the view that motor control stabilisation exercises (MCE) lead to a reduction in pain intensity and disability in non-specific low back pain patients when compared to a control group. In this prospective meta-analysis and sensitivity multilevel meta-regression within the MiSpEx-Network, 18 randomized controlled study arms were included. Participants with non-specific low back pain were allocated to an intervention (individualized MCE, 12 weeks) or a control group (no additive exercise intervention). From each study site/arm, outcomes at baseline, 3 weeks, 12 weeks, and 6 months were pooled. The outcomes were current pain (NRS or VAS, 11 points scale), characteristic pain intensity, and subjective disability. A random effects meta-analysis model for continuous outcomes to display standardized mean differences between intervention and control was performed, followed by sensitivity multilevel meta-regressions. Overall, 2391 patients were randomized; 1976 (3 weeks, short-term), 1740 (12 weeks, intermediate), and 1560 (6 months, sustainability) participants were included in the meta-analyses. In the short-term, intermediate and sustainability, moderate-to-high quality evidence indicated that MCE has a larger effect on current pain (SMD = −0.15, −0.15, −0.19), pain intensity (SMD = −0.19, −0.26, −0.26) and disability (SMD = −0.15, −0.27, −0.25) compared with no exercise intervention. Low-quality evidence suggested that those patients with comparably intermediate current pain and older patients may profit the most from MCE. Motor control stabilisation exercise is an effective treatment for non-specific low back pain. Sub-clinical intermediate pain and middle-aged patients may profit the most from this intervention.
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spelling pubmed-75643522020-10-26 Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects Niederer, Daniel Engel, Tilman Vogt, Lutz Arampatzis, Adamantios Banzer, Winfried Beck, Heidrun Moreno Catalá, María Brenner-Fliesser, Michael Güthoff, Claas Haag, Thore Hönning, Alexander Pfeifer, Ann-Christin Platen, Petra Schiltenwolf, Marcus Schneider, Christian Trompeter, Katharina Wippert, Pia-Maria Mayer, Frank J Clin Med Article Low-to-moderate quality meta-analytic evidence shows that motor control stabilisation exercise (MCE) is an effective treatment of non-specific low back pain. A possible approach to overcome the weaknesses of traditional meta-analyses would be that of a prospective meta-analyses. The aim of the present analysis was to generate high-quality evidence to support the view that motor control stabilisation exercises (MCE) lead to a reduction in pain intensity and disability in non-specific low back pain patients when compared to a control group. In this prospective meta-analysis and sensitivity multilevel meta-regression within the MiSpEx-Network, 18 randomized controlled study arms were included. Participants with non-specific low back pain were allocated to an intervention (individualized MCE, 12 weeks) or a control group (no additive exercise intervention). From each study site/arm, outcomes at baseline, 3 weeks, 12 weeks, and 6 months were pooled. The outcomes were current pain (NRS or VAS, 11 points scale), characteristic pain intensity, and subjective disability. A random effects meta-analysis model for continuous outcomes to display standardized mean differences between intervention and control was performed, followed by sensitivity multilevel meta-regressions. Overall, 2391 patients were randomized; 1976 (3 weeks, short-term), 1740 (12 weeks, intermediate), and 1560 (6 months, sustainability) participants were included in the meta-analyses. In the short-term, intermediate and sustainability, moderate-to-high quality evidence indicated that MCE has a larger effect on current pain (SMD = −0.15, −0.15, −0.19), pain intensity (SMD = −0.19, −0.26, −0.26) and disability (SMD = −0.15, −0.27, −0.25) compared with no exercise intervention. Low-quality evidence suggested that those patients with comparably intermediate current pain and older patients may profit the most from MCE. Motor control stabilisation exercise is an effective treatment for non-specific low back pain. Sub-clinical intermediate pain and middle-aged patients may profit the most from this intervention. MDPI 2020-09-22 /pmc/articles/PMC7564352/ /pubmed/32971921 http://dx.doi.org/10.3390/jcm9093058 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Niederer, Daniel
Engel, Tilman
Vogt, Lutz
Arampatzis, Adamantios
Banzer, Winfried
Beck, Heidrun
Moreno Catalá, María
Brenner-Fliesser, Michael
Güthoff, Claas
Haag, Thore
Hönning, Alexander
Pfeifer, Ann-Christin
Platen, Petra
Schiltenwolf, Marcus
Schneider, Christian
Trompeter, Katharina
Wippert, Pia-Maria
Mayer, Frank
Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects
title Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects
title_full Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects
title_fullStr Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects
title_full_unstemmed Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects
title_short Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects
title_sort motor control stabilisation exercise for patients with non-specific low back pain: a prospective meta-analysis with multilevel meta-regressions on intervention effects
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564352/
https://www.ncbi.nlm.nih.gov/pubmed/32971921
http://dx.doi.org/10.3390/jcm9093058
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