Exercise According to Directional Preference Exercise of Stabilization Recise in Patients with Chronic Low Back Pain: A Randomized, Controlled Trial

Česká verzia

Authors: E. Nováková ¹; S. May ²; M. Říha ¹; P. Král ³
Authors place of work: Oddělení rehabilitační a fyzikální medicíny, Ústřední vojenská nemocnice – Vojenská fakultní nemocnice Praha. ¹; Faculty of Health and WellBeing Research Governance, Sheffield Hallam University, Sheffield, United Kingdom. ²; Ústřední lékařsko – psychologické oddělení, Ústřední vojenská nemocnice – Vojenská fakultní nemocnice Praha. ³
Published in the journal: Rehabil. fyz. Lék., 20, 2013, No. 2, pp. 51-57.
Category: Original Papers

Summary

Study Design:
The aim of this research project was to compare the effectiveness of directional preference exercises with a stabilization exercise program in the management of chronic low back pain and to follow up functional status and pain intensity at discharge from physical therapy at intervals of six months and one year later. All patients met the criteria for recruiting patients consisted of the existence of directional preference and the criteria for the clinical prediction rule for stabilization exercises.

Methods:
Data was gathered from adults (n=62 patients) with chronic low back pain who, on initial assessment, demonstrated a directional preference and an indication that they might respond to stabilization exercises. Patients were then randomized to either directional preference or stabilization exercises and treated for up to four weeks (6 treatments). Outcomes used were the Numeric Pain Rating Scale (NPRS) for back and leg pain, the Roland-Morris Disability Questionnaire (RMDQ) and the Global Perceived Effect Score (GPES), measured after treatment. All data was assumed to be ordinal (RMDQ, NPRS, GPES) so nonparametric tests were used. Analysis of outcomes between groups at different time points was done using ANOVA, and all outcomes’ significance was set at ≤ 0.05.

Results:
Contamination of the data in the stabilization group was a major limitation of the study, with many patients in this group receiving extension exercises as well.

There was a significant difference in both groups over time in all outcomes (P<0.0001), but there were no significant differences between groups at any time point.

Conclusion:
It is not clear if these results are a true comparison between directional preference and stabilization exercises, as there was substantial contamination of the stabilization group treatment.

Keywords:
chronic low back pain, directional preference, stabilization exercise

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