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Segmental stabilizing exercises and low back pain. What is the evidence? A systematic review of randomized controlled trials

Department of Physical Medicine and Rehabilitation, Ludwig-Maximilians-University, Munich, Germany

Rob de Bie

Department of Epidemiology, Maastricht University, The Netherlands

Heribert Limm

Katharina von Garnier

Thomas Ewert

Department of Physical Medicine and Rehabilitation, Ludwig-Maximilians-University, Munich, Germany

Gerold Stucki

Department of Physical Medicine and Rehabilitation, Ludwig-Maximilians-University, Munich, Germany; Swiss Paraplegic Research (SPR), Nottwil, Switzerland

Study design: A systematic review of randomized controlled trials.

Objectives: To evaluate the effectiveness of segmental stabilizing exercises for acute, subacute and chronic low back pain with regard to pain, recurrence of pain, disability and return to work.

Methods: MEDLINE, EMBASE, CINAHL, Cochrane Controlled Trials Register, PEDro and article reference lists were searched from 1988 onward. Randomized controlled trials with segmental stabilizing exercises for adult low back pain patients were included. Four comparisons were foreseen: (1) effectiveness of segmental stabilizing exercises versus treatment by general practitioner (GP); (2) effectiveness of segmental stabilizing exercises versus other physiotherapy treatment; (3) effectiveness of segmental stabilizing exercises combined with other physiotherapy treatment versus treatment by GP and (4) effectiveness of segmental stabilizing exercises combined with other physiotherapy treatment versus other physiotherapy treatment.

Results: Seven trials were included. For acute low back pain, segmental stabilizing exercises are equally effective in reducing short-term disability and pain and more effective in reducing long-term recurrence of low back pain than treatment by GP. For chronic low back pain, segmental stabilizing exercises are, in the short and long term, more effective than GP treatment and may be as effective as other physiotherapy treatments in reducing disability and pain. There is limited evidence that segmental stabilizing exercises additional to other physiotherapy treatment are equally effective for pain and more effective concerning disability than other physiotherapy treatments alone. There is no evidence concerning subacute low back pain.

Conclusion: For low back pain, segmental stabilizing exercises are more effective than treatment by GP but they are not more effective than other physiotherapy interventions.

Clinical Rehabilitation, Vol. 20, No. 7, 553-567 (2006)
DOI: 10.1191/0269215506cr977oa


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