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Open Access Highly Accessed Study protocol

Movement control exercise versus general exercise to reduce disability in patients with low back pain and movement control impairment. A randomised controlled trial

Jeannette Saner1*, Jan Kool1, Rob A de Bie2, Judith M Sieben3 and Hannu Luomajoki1

Author Affiliations

1 Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, Technikumstrasse 71, Postfach, CH - 8401 Winterthur, Switzerland

2 Dept. of Methodology and Statistics, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands

3 Department of Anatomy & Embryology, Maastricht University, Maastricht, The Netherlands

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BMC Musculoskeletal Disorders 2011, 12:207  doi:10.1186/1471-2474-12-207

Published: 23 September 2011

Abstract

Background

Non-specific low back pain (NSLBP) in subacute and chronic stages can be treated effectively with exercise therapy. Research guidelines recommend evaluating different treatments in defined subgroups of patients with NSLBP. A subgroup of patients with movement control impairment (MCI) improved significantly on patient specific function and disability in a previous case series after movement control exercises.

Methods/Design

In a randomised controlled trial (RCT) we will compare the effectiveness of movement control and general exercise in patients with MCI. 106 participants aged 18 - 75 will be recruited in 5 outpatient hospital departments and 7 private practices.

Patients randomly assigned to the movement control exercise group will be instructed to perform exercises according to their MCI. The general exercise group will follow an exercise protocol aimed at improving endurance and flexibility. Patients in both groups will receive 9 - 18 treatments and will be instructed to do additional exercises at home.

The primary outcome is the level of disability assessed using the patient specific functional scale (PSFS) which links the perceived pain to functional situations and is measured before treatment and at 6 and 12 months follow-up. Secondary outcomes concern low back pain related disability (Roland Morris questionnaire, RMQ), graded chronic pain scale (GCPS), range of motion and tactile acuity.

Discussion

To our knowledge this study will be the first to compare two exercise programs for a specific subgroup of patients with NSLBP and MCI. Results of this study will provide insight into the effectiveness of movement control exercise and contribute to our understanding of the mechanisms behind MCI and its relation to NSLBP.

Trial registration

Current Controlled Trials ISRCTN80064281