Specific Exercises based on Sahrmann Questioned!
This 2016 study investigated the efficacy of the Sahrmann classification and exercise approach for patients with chronic low back pain (LBP).
The first group received classification-specific treatments (very specific exercises) and the second group received non classification-specific treatments (general performance training exercises).
Results after 3 months:
- BOTH groups equally improved in their functional scores
- BOTH groups equally plateaued at 6 months
- BOTH groups minimally regressed at 12 months
- BOTH groups equally complied with their exercise programs
- Not the specific treatment but adherence to the general exercises was the most predictive factor to greater improvement
Personal comment: I would have never believed these findings 20 years ago after my Sahrmann training but now I am much more aware of the complexities of LBP. I now fully appreciate how regular non-aggravating movement is the key to recovery irrespective of what movements you prescribe! I of course continue to respect the centralization & peripheralization phenomenon.
Reference: Van Dillen et al Efficacy of classification-specific treatment and adherence on outcomes in people with chronic low back pain. A one-year follow-up, prospective, randomized, controlled clinical trial. Man Ther. 2016 Aug;24:52-64.