Cochrane Review on Motor Control Exercises for LBP

The latest Cochrane database review supports the following statements.

“Exercise is a modestly effective treatment for chronic LBP.”

“Current evidence suggests that no single form of exercise is superior to another.”

You may be asking yourself, ‘surely after 20 years of research, motor control exercises (MCE) specifically targeting the deep trunk muscles must have been proven to be effective by now?’

After reviewing the best available evidence from 29 RCTs and 2400 patients they have reached the following conclusions for chronic LBP:

The evidence supports that MCE is not clinically more effective than other exercises for all follow-up periods and outcomes tested.

The evidence supports that MCE is effective for improving pain and function at short, intermediate and long-term follow-up when compared to a control group/minimal intervention.

The evidence supports that MCE is not clinically more effective than manual therapy interventions for all follow-up periods and outcomes tested.

On a positive note, none of the studies on MCE described any patient reported adverse effects.

“Given the evidence that MCE is not superior to other forms of exercise, the choice of exercise for chronic LBP should probably depend on patient or therapist preferences, therapist training, costs and safety.”(Saragiotto et al 2016)

I share this quote with my patients: “The best exercise is the one that you DO!”

Reference: Saragiotto et al Motor control exercise for chronic non-specific low-back pain. Cochrane Database Syst Rev. 2016 Jan 8;(1):CD012004.