Effect Of Motor Control Exercises Research Articles

Comparison of General Exercises, Motor Control Exercises and Spinal Manipulation in Chronic Low Back Pain Patients

Objective: To compare the effects of motor control exercises, general exercises and spinal manipulative therapy on pain, functional status and disability in chronic low back pain patients. Study Design: Randomized Clinical Trial (IRCT:20200511047391N1) Place and Duration of Study: Riphah International University, Islamabad Pakistan, from Jun to Nov 2020. Methodology: Study was conducted on 36 chronic low back pain patients aged 18-50 years. All were randomly allocated to three groups: general exercises group, motor control group, and manipulative therapy; all were treated with eight sessions in four weeks. Numerical pain rating scale, Patient-specific functional scale and Oswestry disability index were used. Results: Findings revealed that differences between the three groups were statistically significant (p<0.05) concerning pain score, patient-specific functional scale, and Disability index. Conclusion: It was concluded that motor control exercises are most effective in treating chronic low backache. The results of our study showed that there is a significant difference in pain, function and disability in all the groups.

Effects of Motor Control Exercises in Patients With Chronic Nonspecific Low Back Pain: A Systematic Review and Meta-Analysis.

The primary objective of this systematic review is to assess whether motor control exercises consisting of the methodology described by Richardson and Hodges improve the pain and disability of patients with nonspecific low back pain. Systematic review and a meta-analysis. A literature review was conducted using PubMed, PEDro, Scielo, CINAHL, Web of Science, Dialnet, Scopus, and MEDLINE from inception to November 2021. Patients with chronic nonspecific low back pain. Randomized controlled trials assessing motor control exercises versus inactive control, placebo or minimal intervention, and other exercises. Pain intensity, disability, and physical activity were considered as primary outcomes. Eighteen studies with 1356 patients were finally included in the systematic review, of which only 13 randomized clinical trials could be meta-analyzed. Statistically significant results were found in favor of the motor control group for the comparison with other exercises in disability at postintervention term (Mean Difference, 95% Confidence Interval [CI], -3.13 [-5.87 to -0.38], P = 0.03); for the comparison with inactive control, placebo, or minimal intervention in pain at postintervention term (MD, 95% CI, -18.10 [-30.79 to -5.41], P = 0.008); and for comparison with general exercises (MD, 95% CI, -12.70 [-20.80 to -4.60], P = 0.002). Moderate-quality evidence regarding the effectiveness of motor control exercises to reduce pain intensity and disability exists, but the reduction should be interpreted with caution.

Effectiveness of motor control exercise, aerobic walking, and muscle strengthening programs in improving outcomes in a subgroup of population with chronic low back pain positive for central sensitization: a study protocol for a randomized controlled trial

BackgroundThe role of pain sensitivity in the development and maintenance of chronic pain states, impaired executive functioning, and patient recovery is being investigated. Conditioned pain modulation (CPM) is widely used to measure musculoskeletal pain associated with central sensitization (CS). Despite the recommendations of many reviews and clinical practice guidelines that exercise programs reduce pain and disability, the overall confidence in these results is considered “critically low.” The “active ingredient” of exercise programs and the dominant factor influencing CPM remain largely unknown.The objectives of this trial are to determine:• If different exercises cause different results on the CPM in a subgroup of people with chronic low back pain (CLBP) who are labeled as having CS pain,• If a program of exercise interventions for 12 weeks would alter executive functioning, quality of life (QoL), disability, and pain in persons with CLBP.• The relationship between patient characteristics, executive functions, CPM, and QoLMethodsThe trial is a randomized, controlled, multi-center study with four experimental groups and one healthy control group. Both the researchers and the people in the study will be blinded to the results. This paper describes the protocol for a trial examining the effects of 12-week individualized, twice-weekly exercise sessions lasting 30 to 60 min in persons with CLBP, who are positive for CS. Participants will be randomized to receive either patient education with motor control exercises (MCE), superficial strengthening (SS), aerobic exercises (AE), or patient education alone. Another group comprised of healthy volunteers will serve as controls. The primary outcomes are changes in CPM outcomes as measured by the cold pressor test (CPT). The secondary objectives are to evaluate executive functioning, pain, disability, quality of life, and spine muscle strength. The outcomes will be measured at 3 months and at a 6-month follow-up.DiscussionThe outcomes of the study will help in gaining more information and evidence about exercise-induced analgesia from the perspective of CPM. Measuring exercise outcomes will aid in scientifically prescribing exercise prescriptions in people with CLBP. The study outcomes will also assist in identifying the characteristics of individuals who will respond or respond indifferently to exercises. Investigating the relationship between the study’s various outcomes could provide information for future trials.Trial registrationClinical Trials Registry of India (CTRI) identifier: CTRI/2022/03/041143. Registered on 16 March 2022.

Effectiveness of motor control exercise on non-specific chronic low back pain, disability and core muscle morphological characteristics: a meta-analysis of randomized controlled trials.

Chronic low back pain (CLBP) has been recognized as the leading cause of disability. Up to 90% of patients with CLBP are classified as having non-specific CLBP (NSCLBP). Motor control exercise (MCE) is one of the most popular and widespread treatment options, and has many advantages in alleviating pain and disability. This meta-analysis is aimed to investigate the effectiveness of MCE on NSCLBP, disability, and core muscles reported in randomized controlled trials (RCTs). PubMed, Web of Science, and EMBASE were searched from inception to August 2020. Articles were eligible if they were RCTs that evaluated MCE against sham or other treatments in isolation and measured outcomes including pain intensity and disability or core muscles morphologic characteristics. Two authors independently extracted the data. Eighteen studies of 894 studies with a total of 1333 individuals with NSCLBP were retained for the meta-analysis. Compared with other conservative treatments, MCE was better in reducing pain and disability posttreatment and was better in reducing pain at the 6-month follow-up period. However, it had comparable effects on pain reduction at 12-month and 24-month follow-up period, and on disability at the 6-month, 12-month and 24-month follow-up period. MCE resulted in comparable effects to other treatments in improving the core muscle thickness posttreatment. Low to very low quality of evidence supported that MCE resulted in a greater reduction of pain and disability posttreatment, and a greater reduction of pain at the 6-month follow-up than other treatments for NSCBLP. The findings in this review further support that MCE may be more effective than other treatments at short-term follow-ups, and at least has equivalent long-term effects to other forms of treatments in NSCLBP.

Sustainability effects of motor control stabilisation exercises on pain and function in chronic nonspecific low back pain patients: A systematic review with meta-analysis and meta-regression

Systematic review with meta-analysis and meta-regression. We systematically reviewed and delineated the existing evidence on sustainability effects of motor control exercises on pain intensity and disability in chronic low back pain patients when compared with an inactive or passive control group or with other exercises. Secondary aims were to reveal whether moderating factors like the time after intervention completion, the study quality, and the training characteristics affect the potential sustainability effects. Relevant scientific databases (Medline, Web of Knowledge, Cochrane) were screened. Eligibility criteria for selecting studies: All RCTs und CTs on chronic (≥ 12/13 weeks) nonspecific low back pain, written in English or German and adopting a longitudinal core-specific/stabilizing sensorimotor control exercise intervention with at least one pain intensity and disability outcome assessment at a follow-up (sustainability) timepoint of ≥ 4 weeks after exercise intervention completion. From the 3,415 studies that were initially retrieved, 10 (2 CTs & 8 RCTs) on N = 1081 patients were included in the review and analyses. Low to moderate quality evidence shows a sustainable positive effect of motor control exercise on pain (SMD = -.46, Z = 2.9, p < .001) and disability (SMD = -.44, Z = 2.5, p < .001) in low back pain patients when compared to any control. The subgroups' effects are less conclusive and no clear direction of the sustainability effect at short versus mid versus long-term, of the type of the comparator, or of the dose of the training is given. Low quality studies overestimated the effect of motor control exercises.

Effect of motor control exercises with spinal manual therapy on pain, range of motion and postural balance in chronic low back pain

Effect of motor control exercises with spinal manual therapy on pain, range of motion and postural balance in chronic low back pain

Effect of motor control exercises on psychological variables in chronic low back pain in computer professionals

An 80% of individuals in the world suffer with low back pain and 76% of computer users suffer with various musculoskeletal disorders. Reasons for these disorders are poor posture, use of awkward sitting and static positioning for longer duration. Studies have addressed on the management of low back pain but, lack of evidences. Purpose of the study is to determine the effect of motor control exercises on psychological variables in chronic low back pain in computer professionals. 44 subjects with chronic low back pain were selected using convince sampling method and they all included upon assessment and based on selection criteria. Experimental group underwent motor control exercises based on O’Sullivan and Moseley protocols, where as Home exercises were advised to the control group. Outcomes measured were Roland Morris disability index for functional disability and Beck depression inventory for psychological variable. Results were analysed using student ’t’ test, it found 23.67 (P< 0.05%) for the Beck depression inventory and 5.40 (P< 0.05%) Roland morris disability index. The study concludes the experimental group show greater reduction in disability and depression when compared with the control group.

Effects of Motor Control Exercise Vs Muscle Stretching Exercise on Reducing Compensatory Lumbopelvic Motions and Low Back Pain: A Randomized Trial

ObjectivesThe purpose of this study was to investigate the effectiveness of a 6-week motor control exercise (MCE) vs stretching exercise (SE) on reducing compensatory pelvic motion during active prone knee flexion (APKF) and intensity of low back pain. MethodsThirty-six people in the lumbar-rotation-extension subgroup were randomly assigned equally into 2 exercise groups (18 people in each an MCE or SE group). A 3-dimensional motion-analysis system was used to measure the range and onset time of pelvic motion and knee flexion during APKF. Surface electromyography was used to measure the muscle activity and onset time of the erector spinae and the hamstrings during APKF. The level of subjective low back pain was measured using a visual analog scale. ResultsThe MCE group had more significant decreases in and delay of anterior pelvic tilt, pelvic rotation, and erector spinae muscle activity during APKF, as well as reduced intensity of low back pain compared with the SE group (P < .05). ConclusionsFor rehabilitation in patients in the lumbar-rotation-extension subgroup, MCE was more effective than SE in reducing compensatory pelvic motion and muscle activity during APKF and minimizing low back pain.

Motor control exercise for symptomatic lumbar disc herniation: protocol for a systematic review and meta-analysis.

IntroductionLumbar disc herniation (LDH) is a common condition in adults and can impose a heavy burden on both the individual and society. It is defined as displacement of disc components beyond the intervertebral disc space. Various conservative treatments have been recommended for the treatment of LDH and physical therapy plays a major role in the management of patients. Therapeutic exercise is effective for relieving pain and improving function in individuals with symptomatic LDH. The aim of this systematic review is to evaluate the effectiveness of motor control exercise (MCE) for symptomatic LDH.Methods and analysisWe will include all clinical trial studies with a concurrent control group which evaluated the effect of MCEs in patients with symptomatic LDH. We will search PubMed, SCOPUS, PEDro, SPORTDiscus, CINAHL, CENTRAL and EMBASE with no restriction of language. Primary outcomes of this systematic review are pain intensity and functional disability and secondary outcomes are functional tests, muscle thickness, quality of life, return to work, muscle endurance and adverse events. Study selection and data extraction will be performed by two independent reviewers. The assessment of risk of bias will be implemented using the PEDro scale. Publication bias will be assessed by funnel plots, Begg's and Egger's tests. Heterogeneity will be evaluated using the I2 statistic and the χ2 test. In addition, subgroup analyses will be conducted for population and the secondary outcomes. All meta-analyses will be performed using Stata V.12 software.Ethics and disseminationNo ethical concerns are predicted. The systematic review findings will be published in a peer-reviewed journal and will also be presented at national/international academic and clinical conferences.Trial registration numberCRD42016038166.

Motor Control Exercise for Nonspecific Low Back Pain: A Cochrane Review.

A systematic review. The aim of this review was to evaluate the effectiveness of motor control exercise (MCE) in patients with nonspecific low back pain (LBP). MCE is a common form of exercise used for managing LBP. MCE focuses on the activation of the deep trunk muscles and targets the restoration of control and coordination of these muscles, progressing to more complex and functional tasks integrating the activation of deep and global trunk muscles. We conducted electronic searches of CENTRAL, MEDLINE, EMBASE, five other databases, and two trials registers from their inception up to April 2015. Two independent review authors screened the search results, assessed risk of bias, and extracted the data. A third reviewer resolved any disagreement. We included randomized controlled trials comparing MCE with no treatment, another treatment, or as a supplement to other interventions in patients with nonspecific LBP. Primary outcomes were pain intensity and disability. We assessed risk of bias using the Cochrane Back and Neck (CBN) Review Group 12-item criteria. We combined results in a meta-analysis expressed as mean difference and 95% confidence interval. We assessed the overall quality of the evidence using the GRADE approach. We included 32 trials (n = 2628). Most included trials had a low risk of bias. For acute LBP, low to moderate quality evidence indicates no clinically important differences between MCE and spinal manipulative therapy or other forms of exercise. There is very low-quality evidence that the addition of MCE to medical management does not provide clinically important improvements. For recurrence at one year, there is very low-quality evidence that MCE and medical management decrease the risk of recurrence. For chronic LBP, there is low to moderate quality evidence that MCE is effective for reducing pain compared with minimal intervention. There is low to high-quality evidence that MCE is not clinically more effective than other exercises or manual therapy. There is very low to low quality evidence that MCE is clinically more effective than exercise and electrophysical agents (EPAs) or telerehabilitation for pain and disability. MCE is probably more effective than a minimal intervention for reducing pain, but probably does not have an important effect on disability, in patients with chronic LBP. There was no clinically important difference between MCE and other forms of exercises or manual therapy for acute and chronic LBP. 1.

EFFECTIVENESS OF CORE STABILIZATION EXERCISES AND MOTOR CONTROL EXERCISES IN PATIENTS WITH LOW BACK ACHE

Background: Motor control exercises are isolated strengthening exercise for the deep spinal muscles (transverse abdominus, multifidus) whereas Core stability is achieved by global strengthening of the core muscles. There are not much studies available in the literature done or studied the short term effect of the motor control and core stabilization on subjects with low back pain. Therefore, the purpose of this study to find the comparative effect of motor control exercises versus core stabilization exercises on improvement of pain and disability in subjects with mechanical low back pain.Method: An experimental study design, 30 subjects with non-specific mechanical low back pain were randomized into 2 groups with 15 subjects each in Group A and Group B. Subjects in Group A received Motor control exercises and subjects in Group B received Core stability exercises. Both the group received conventional exercises. The duration of intervention was given for two weeks. Outcome measurements such as pain using VAS, Functional disability using Oswestry Disability Index Questionnaire were measured before and after two weeks of intervention.Results: Analysis using paired ‘t’ test and wilcoxon signed rank test found that there is a statistically significant improvement (p<0.05) in pain, functional disability within the groups. Comparative analysis using independent ‘t’ test and Mann Whitney U test for comparison of difference in improvement in VAS and ODI between two groups, it was found that there was significant difference in improvement of VAS and ODI between groups. Group-A showed better improvement in VAS and ODI compared to Group B with an effect size of 1.47 and 0.99 respectively.Conclusion: It is concluded that the Motor control exercises showed statistically significant improvement in reducing back pain and disability when compared to the Core Stabilization exercises. Thus, performing Motor Control exercises reduces pain and disability significantly compared to Core stabilization among non specific mechanical low back ache subjects.

A Study to Analyze the Effect of Motor Control Exercises on Pain and Functional Disability in Patients with Mechanical Low Back Pain

A Study to Analyze the Effect of Motor Control Exercises on Pain and Functional Disability in Patients with Mechanical Low Back Pain

Effect of Motor Control Exercises on Pain and Mobility in Professional Drivers Having Occupational Low Back Pain

Background and objective: The motor control exercises have been found to be effective in activating the deep trunk muscles. The aim of this study was to determine the effect of motor control exercise (stabilization exercise) on pain and mobility in professional drivers having Occupational low back pain. Design: Experimental study design Methods: Thirty male subjects having low back pain with the history of driving and age between 25 and 40 years were recruited from auto and taxi stands in Dehradun. Subjects were divided into two groups: one is Group A and another is Group B each having 15 subjects. Subjects in group A were given the motor control exercises and back extension exercises while subjects in group B were given only the back extension exercises. This was a four week exercise program. Pain and Performance were assessed Pre-intervention, Midintervention and Post-intervention using Visual Analogue Scale (VAS) and Back Performance Scale (BPS) respectively. Within-group and between-group comparison of all three readings was done. Results: The results showed insignificant improvement in pain and performance of both the groups from the 0 day to 4 th week of intervention. The difference between the improvements shown by both groups was also found to be insignificant. Conclusion: From the above results, it was concluded that the motor control exercises are equally effective to other back extension exercises in reducing pain and increasing mobility in professional drivers having occupational LBP.

Macedo LG, Latimer J, Maher CG, et al. “Effect of motor control exercises versus graded activity in patients with chronic nonspecific low back pain: a randomized controlled trial.” Phys Ther. 2012;92:363–377.

Macedo LG, Latimer J, Maher CG, et al. “Effect of motor control exercises versus graded activity in patients with chronic nonspecific low back pain: a randomized controlled trial.” Phys Ther. 2012;92:363–377.

Motor Control Exercise for Persistent, Nonspecific Low Back Pain: A Systematic Review

Previous systematic reviews have concluded that the effectiveness of motor control exercise for persistent low back pain has not been clearly established. The objective of this study was to systematically review randomized controlled trials evaluating the effectiveness of motor control exercises for persistent low back pain. Electronic databases were searched to June 2008. Pain, disability, and quality-of-life outcomes were extracted and converted to a common 0 to 100 scale. Where possible, trials were pooled using Revman 4.2. Fourteen trials were included. Seven trials compared motor control exercise with minimal intervention or evaluated it as a supplement to another treatment. Four trials compared motor control exercise with manual therapy. Five trials compared motor control exercise with another form of exercise. One trial compared motor control exercise with lumbar fusion surgery. The pooling revealed that motor control exercise was better than minimal intervention in reducing pain at short-term follow-up (weighted mean difference=-14.3 points, 95% confidence interval [CI]=-20.4 to -8.1), at intermediate follow-up (weighted mean difference=-13.6 points, 95% CI=-22.4 to -4.1), and at long-term follow-up (weighted mean difference=-14.4 points, 95% CI=-23.1 to -5.7) and in reducing disability at long-term follow-up (weighted mean difference=-10.8 points, 95% CI=-18.7 to -2.8). Motor control exercise was better than manual therapy for pain (weighted mean difference=-5.7 points, 95% CI=-10.7 to -0.8), disability (weighted mean difference=-4.0 points, 95% CI=-7.6 to -0.4), and quality-of-life outcomes (weighted mean difference=-6.0 points, 95% CI=-11.2 to -0.8) at intermediate follow-up and better than other forms of exercise in reducing disability at short-term follow-up (weighted mean difference=-5.1 points, 95% CI=-8.7 to -1.4). Motor control exercise is superior to minimal intervention and confers benefit when added to another therapy for pain at all time points and for disability at long-term follow-up. Motor control exercise is not more effective than manual therapy or other forms of exercise.

Motor control or graded activity exercises for chronic low back pain? A randomised controlled trial

BackgroundChronic low back pain remains a major health problem in Australia and around the world. Unfortunately the majority of treatments for this condition produce small effects because not all patients respond to each treatment. It appears that only 25–50% of patients respond to exercise. The two most popular types of exercise for low back pain are graded activity and motor control exercises. At present however, there are no guidelines to help clinicians select the best treatment for a patient. As a result, time and money are wasted on treatments which ultimately fail to help the patient.MethodsThis paper describes the protocol of a randomised clinical trial comparing the effects of motor control exercises with a graded activity program in the treatment of chronic non specific low back pain. Further analysis will identify clinical features that may predict a patient's response to each treatment. One hundred and seventy two participants will be randomly allocated to receive either a program of motor control exercises or graded activity. Measures of outcome will be obtained at 2, 6 and 12 months after randomisation. The primary outcomes are: pain (average pain intensity over the last week) and function (patient-specific functional scale) at 2 and 6 months. Potential treatment effect modifiers will be measured at baseline.DiscussionThis trial will not only evaluate which exercise approach is more effective in general for patients will chronic low back pain, but will also determine which exercise approach is best for an individual patient.Trial registration numberACTRN12607000432415