Effects of Different Trunk Training Methods for Chronic Low Back Pain: A Meta-Analysis.

Dhananjaya Sutanto,Yijian Yang,Robin S T Ho,Eric T C Poon,Stephen H S Wong

doi:10.3390/ijerph19052863

Abstract

We conducted a systematic review and meta-analysis comparing motor control, isometric, and isotonic trunk training intervention for pain, disability, and re-injury risk reduction in chronic low back pain patients. The EMBASE, MEDLINE, CENTRAL, PsycINFO, SPORTDiscus, and CINAHL databases were searched from inception until 25 February 2021 for chronic low back pain intervention based on any trunk training. Outcomes include the Oswestry Disability Index (ODI) and Roland Morris Disability Questionnaire (RMDQ) for disability, the Numerical Pain Rating Scale (NPRS) for pain, and the Sorensen Test (ST) for future risk of re-injury. Isometric training was superior to the control with a mean difference (MD) = −1.66, 95% confidence interval (CI) [−2.30, −1.01] in pain reduction; MD = −7.94, 95% CI [−10.29, −5.59] in ODI; MD = −3.21, 95% CI [−4.83, −1.60] in RMDQ; and MD = 56.35 s, 95% CI [51.81 s, 60.90 s] in ST. Motor control was superior to the control with a MD = −2.44, 95% CI [−3.10, −1.79] in NPRS; MD = −8.32, 95% CI [−13.43, −3.22] in ODI; and MD = −3.58, 95% CI [−5.13, −2.03] in RMDQ. Isometric and motor control methods can effectively reduce pain and disability, with the isometric method reducing re-injury risk.

Highlights

This study aimed to evaluate and synthesise the comparative effectiveness of Motor control (MC), IM, and IT trunk training methods using a meta-analysis based on validated outcomes
Clinicians can prescribe trunk muscle training, focusing on deep abdominal muscle activation (MC method) such as the abdominal draw-in-manoeuvre or isometric trunk muscle activation (IM method) such as the plank for patients with chronic low back pain (CLBP). Both training approaches can be effective as both methods train the trunk muscle endurance to hold the spine in a neutral position including during active daily living
As the spine in a neutral position is more resilient to tissue injury, CLBP patients trained in the MC and IM methods could gradually experience pain and disability reduction

Summary

Introduction

Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Department of Health and Physical Education, The Education University of Hong Kong, Taipo, Hong Kong; Abstract: We conducted a systematic review and meta-analysis comparing motor control, isometric, and isotonic trunk training intervention for pain, disability, and re-injury risk reduction in chronic low back pain patients. The EMBASE, MEDLINE, CENTRAL, PsycINFO, SPORTDiscus, and CINAHL databases were searched from inception until 25 February 2021 for chronic low back pain intervention based on any trunk training. Outcomes include the Oswestry Disability Index (ODI) and Roland

Objectives

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Discussion

Conclusion