Elsevier

Physical Therapy in Sport

Volume 23, January 2017, Pages 136-142
Physical Therapy in Sport

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

https://doi.org/10.1016/j.ptsp.2016.08.004Get rights and content

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.

Abstract

Aim

We 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.

Design

We searched MEDLINE, Cochrane Controlled Trials, Scielo, and CINAHL (from the earliest date available to November 2014) for randomized controlled trials that examined the efficacy of stabilization exercises compared to general exercises or manual therapy on pain, disability, and function in patients with low back pain. Weighted mean differences (WMD) and 95% confidence intervals were calculated.

Results

Eleven studies met the inclusion criteria (413 stabilization exercises patients, 297 general exercises patients, and 185 manual therapy patients). 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.

Conclusions

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.

Section snippets

Background

Low back pain (LBP) is a multifactorial disorder with a high prevalence; most people experience back pain at some point in their life and it has a significant impact on individuals, their families, and the healthcare systems. This disorder causes disability, participation restriction, a career burden, the use of health-care resources, and a financial burden. In addition to medical treatment, musculoskeletal physiotherapy (exercise therapy and manual therapy) is the most common method of

Methods

This review was planned and performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (Moher et al., 2009).

Results

The initial search led to the identification of 653 abstracts, from which 24 studies were considered as potentially relevant and were retrieved for detailed analysis. After complete reading of 24 articles, 13 were excluded. Finally, 11 papers (Akbari et al., 2008, Amit et al., 2013, Ferreira et al., 2007, França et al., 2010, França et al., 2012, Goldby et al., 2006, Inani and Selkar, 2013, Macedo et al., 2012, Rasmussen-Barr et al., 2003, Sung, 2013, Unsgaard-Tøndel et al., 2010) met the

Discussion

In the present systematic review, a meta-analysis of 8 studies indicated that stabilization exercises were more effective than general exercises in reducing pain. Five studies demonstrated a significant improvement in disability between patients treated with stabilization exercises compared with those treated with general exercises. Moreover, the meta-analysis of three studies demonstrated that stabilization exercises were as efficacious as manual therapy in decreasing pain and disability.

In

Conclusion

Stabilization exercises and/or manual therapy can be encouraged as part of musculoskeletal rehabilitation for patients with LBP. However, the best prescription program, needs to be determined by new RCTs.

Conflict of interest

None.

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