Stabilization exercise compared to general exercises or manual therapy for the management of low back pain: A systematic review and meta-analysis

Neto MG, Lopes JM, Conceição CS, Araujo A, Brasileiro A, Sousa C, Carvalho VO, & Archanjo FL. Physical Therapy in Sport. 2016; Epub ahead of print Accepted August 9, 2016. doi: 10.1016/j.ptsp.2016.08.004

http://www.physicaltherapyinsport.com/article/S1466-853X(16)30071-2/fulltext?rss=yes

Article Highlights:

• Stabilization exercises improved pain and disability compared with general exercises.
• Stabilization exercises does not provide greater benefit than manual therapy for pain and disability.
• Stabilization exercises or manual therapy should be considered a mode of treatment.
• Methodologically sound studies on the efficacy of stabilization exercises are warranted.

The authors performed performed a systematic review with a meta-analysis to examine the efficacy of stabilization exercises versus general exercises or manual therapy in patients with low back pain. While supervised exercise including stabilization training is often recommended for people with chronic non-specific low back pain. There is however, conflicting research as to whether it is successful in reducing pain and disability. The authors conducted a systematic review and meta-analysis of randomized clinical trials among people without leg pain and with low back symptoms for > 3 months. They evaluated the quality and outcomes of 11 trials, which had 413 participants with stabilization exercises, 297 with general exercises, and 185 with manual therapy. Stabilization exercises may provide greater benefit than general exercise for pain reduction and improvement in disability. Stabilization exercise improved pain with a WMD of −1.03 (95% CI: −1.29 to −0.27) and improved disability with a WMD of −5.41 (95% CI: −8.34 to −2.49). There were no significant differences in pain and disability scores among participants in the stabilization exercise group compared to those in the manual therapy group. Overall, the authors found that participants who completed stabilization exercises had greater pain and disability improvements in comparison to general exercises. However, there were no differences in function reported. The authors concluded that the findings of this this research does reinforce the concept that stabilization exercises or manual therapy may be a better choice for chronic non-specific low back pain than general exercises for improving outcomes. Stabilization exercises were as efficacious as manual therapy in decreasing pain and disability and should be encouraged as part of musculoskeletal rehabilitation for low back pain.