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Comparison of spinal stability following motor control and general exercises in nonspecific chronic low back pain patients

      Highlights

      • Fifty-one patients received motor control or general rehabilitation exercises.
      • Two groups were compared based on stability indices before and after interventions.
      • Spinal stability was evaluated before/after interventions with an EMG-driven model.
      • Generally, the exercises did not significantly change stability indices (SIs).
      • There was no significant difference between two exercises in changing SIs.

      Abstract

      Background

      Motor control exercise was claimed to improve spinal stability in patients with chronic non-specific back pain, but to investigate the effectiveness of this exercise, other outcome measures have been used rather than spinal stability itself. The aim of our study is to assess motor control exercise effects on spinal stability using a biomechanical model.

      Methods

      Fifty-one patients were assigned to either motor control or general exercises. Before and after trainings, participants were tested for spinal stability at seven isometric tasks. Electromyography signals were recorded from ten superficial muscles, and a hybrid EMG-driven musculoskeletal model estimated spinal stability indices at each task.

      Findings

      Pain and disability significantly decreased in both groups. After trainings, patients had both increase and decrease in stability depending on the task, and stability did not increase/decrease uniformly in all patients. In the motor control group, stability increased at all positions but reached to significance only at right lateral pulling. In the general exercise group, except for pulling the trunk backward, stability decreased at other positions and reached to statistical significance only at pulling the trunk forward. No significant difference between groups was found in changing stability after the intervention.

      Interpretation

      Interventions yielded no significant difference in disability, pain and stability index between two groups. Significant increase of stability in the motor control group at right lateral pulling may be attributed to more activity of abdominal muscles, and significant decrease of stability in the general exercise group at forward pulling may be attributed to more optimal activity of back muscles.

      Keywords

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