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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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Main Authors: Niederer, Daniel (Author) , Engel, Tilman (Author) , Vogt, Lutz (Author) , Arampatzis, Adamantios (Author) , Banzer, Winfried (Author) , Beck, Heidrun (Author) , Moreno Catalá, María (Author) , Brenner-Fliesser, Michael (Author) , Güthoff, Claas (Author) , Haag, Thore (Author) , Hönning, Alexander (Author) , Pfeifer, Ann-Christin (Author) , Platen, Petra (Author) , Schiltenwolf, Marcus (Author) , Schneider, Christian (Author) , Trompeter, Katharina (Author) , Wippert, Pia-Maria (Author) , Mayer, Frank (Author)
Format: Article (Journal)
Language:English
Published: 22 September 2020
In: Journal of Clinical Medicine
Year: 2020, Volume: 9, Issue: 9
ISSN:2077-0383
DOI:10.3390/jcm9093058
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/jcm9093058
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2077-0383/9/9/3058
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Author Notes:Daniel Niederer, Tilman Engel, Lutz Vogt, Adamantios Arampatzis, Winfried Banzer, Heidrun Beck, María Moreno Catalá, Michael Brenner-Fliesser, Claas Güthoff, Thore Haag, Alexander Hönning, Ann-Christin Pfeifer, Petra Platen, Marcus Schiltenwolf, Christian Schneider, Katharina Trompeter, Pia-Maria Wippert and Frank Mayer
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Summary: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.
Item Description:Gesehen am 17.12.2020
Physical Description:Online Resource
ISSN:2077-0383
DOI:10.3390/jcm9093058

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