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BMC Musculoskeletal Disorders

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Open Access 01-12-2012 | Research article

Modifying patterns of movement in people with low back pain -does it help? A systematic review

Authors: Robert A Laird, Peter Kent, Jennifer L Keating

Published in: BMC Musculoskeletal Disorders | Issue 1/2012

Abstract

Background

Physiotherapy for people with low back pain frequently includes assessment and modification of lumbo-pelvic movement. Interventions commonly aim to restore normal movement and thereby reduce pain and improve activity limitation. The objective of this systematic review was to investigate: (i) the effect of movement-based interventions on movement patterns (muscle activation, lumbo-pelvic kinematics or postural patterns) of people with low back pain (LBP), and (ii) the relationship between changes in movement patterns and subsequent changes in pain and activity limitation.

Methods

MEDLINE, Cochrane Central, EMBASE, AMI, CINAHL, Scopus, AMED, ISI Web of Science were searched from inception until January 2012. Randomised controlled trials or controlled clinical trials of people with LBP were eligible for inclusion. The intervention must have been designed to influence (i) muscle activity patterns, (ii) lumbo-pelvic kinematic patterns or (iii) postural patterns, and included measurement of such deficits before and after treatment, to allow determination of the success of the intervention on the lumbo-pelvic movement. Twelve trials (25% of retrieved studies) met the inclusion criteria. Two reviewers independently identified, assessed and extracted data. The PEDro scale was used to assess method quality. Intervention effects were described using standardised differences between group means and 95% confidence intervals.

Results

The included trials showed inconsistent, mostly small to moderate intervention effects on targeted movement patterns. There was considerable heterogeneity in trial design, intervention type and outcome measures. A relationship between changes to movement patterns and improvements in pain or activity limitation was observed in one of six studies on muscle activation patterns, one of four studies that examined the flexion relaxation response pattern and in two of three studies that assessed lumbo-pelvic kinematics or postural characteristics.

Conclusions

Movement-based interventions were infrequently effective for changing observable movement patterns. A relationship between changes in movement patterns and improvement in pain or activity limitation was also infrequently observed. No independent studies confirm any observed relationships. Challenges for future research include defining best methods for measuring (i) movement aberrations, (ii) improvements in movements, and (iii) the relationship between changes in how people move and associated changes in other health indicators such as activity limitation.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2474/13/169/prepub

Title: Modifying patterns of movement in people with low back pain -does it help? A systematic review
Authors: Robert A Laird
Peter Kent
Jennifer L Keating
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2012
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/1471-2474-13-169

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Modifying patterns of movement in people with low back pain -does it help? A systematic review

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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