Stabilization vs. exercises or manual therapy for LBP

This systematic review found that stabilization exercises may provide a greater reduction in pain and disability compared to general exercises, but no significant differences compared to manual therapy in the management of low back pain.

Low back pain (LBP) is the most frequent musculoskeletal complaint. It is a multifactorial disorder associated with a massive financial burden and loss of work and activity participation. Exercise and manual therapy are the most common conservative interventions in the management of LBP. This review includes the most recent randomized controlled trials and compares stabilization exercises and manual therapy for the first time.

11 articles were included in the review, with samples from 30 to 172 participants with chronic non-specific LBP. Article quality ranged from moderate to good, according to the PEDro scale. The outcome measures assessed were pain (visual analogue scale) and disability (Roland-Morris disability questionnaire, RMDQ and Oswestry Disability Index, ODI).

Stabilization exercises were found to produce a greater reduction in pain (7 trials) and disability according to the ODI (5 trials) compared to general exercises. No differences were found in pain reduction (3 trials) between stabilization and general exercises. Disability levels according to the RMDQ between stabilization and general exercises (2 trials) and between stabilization exercises and manual therapy (3 trials) also showed no significant differences. Pooled results show stabilization exercises may be effective in reducing pain in patients with chronic non-specific LBP, but specific prescription measures are still unclear.

> From: Gomes-Neto et al., Phys Ther Sport 23 (2017) 136-142. All rights reserved to Elsevier Ltd. Click here for the online summary.