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Evaluation of specific stabilizing
exercise in the treatment of chronic low back pain with radiologic
diagnosis of spondylolysis or spondylolisthesis. |
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AUTHORS: |
O'Sullivan PB; Phyty GD; Twomey LT; Allison GT |
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AUTHOR AFFILIATION: |
School of Physiotherapy,
Curtin University of Technology, Western Australia. |
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SOURCE: |
Spine 1997 Dec
15;22(24):2959-67 |
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CITATION IDS: |
PMID: 9431633 UI: 98093701 |
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ABSTRACT: |
STUDY DESIGN: A randomized,
controlled trial, test--retest design, with a 3-, 6-, and 30-month postal questionnaire
follow-up. OBJECTIVE: To determine the efficacy of a specific exercise intervention in the
treatment of patients with chronic low back pain and a radiologic diagnosis of
spondylolysis or spondylolisthesis. SUMMARY OF BACKGROUND DATA: A recent focus in the
physiotherapy management of patients with back pain has been the specific training of
muscles surrounding the spine (deep abdominal muscles and lumbar multifidus), considered
to provide dynamic stability and fine control to the lumbar spine. In no study have
researchers evaluated the efficacy of this intervention in a population with chronic low
back pain where the anatomic stability of the spine was compromised. METHODS: Forty-four
patients with this condition were assigned randomly to two treatment groups. The first
group underwent a 10-week specific exercise treatment program involving the specific
training of the deep abdominal muscles, with co-activation of the lumbar multifidus
proximal to the pars defects. The activation of these muscles was incorporated into
previously aggravating static postures and functional tasks. The control group underwent
treatment as directed by their treating practitioner. RESULTS: After intervention, the
specific exercise group showed a statistically significant reduction in pain intensity and
functional disability levels, which was maintained at a 30-month follow-up. The control
group showed no significant change in these parameters after intervention or at follow-
up. SUMMARY: A "specific exercise" treatment approach appears more effective
than other commonly prescribed conservative treatment programs in patients with
chronically symptomatic spondylolysis or spondylolisthesis. |
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MAIN MESH HEADINGS: |
*Exercise Therapy
Joint Instability/*therapy
Low Back Pain/*therapy
Spondylolisthesis/*radiography
Spondylolisthesis/*therapy
Spondylolysis/*radiography
Spondylolysis/*therapy |
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ADDITIONAL MESH HEADINGS: |
Adult
Chronic Disease
Disability Evaluation
Female
Human
Joint Instability/physiopathology
Low Back Pain/physiopathology
Lumbosacral Region
Male
Pain Measurement
Physical Therapy
Spondylolisthesis/physiopathology
Spondylolysis/physiopathology
Treatment Outcome |
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PUBLICATION TYPES: |
CLINICAL TRIAL
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL |
