Stabilisation exercises for low back pain: a systematic review

Objectives To examine the literature to determine if stabilisation exercises are effective for the treatment of pain and dysfunction in patients with low back pain. Data sources PubMed (MEDLINE), CINAHL, AMED, PEDro and the Cochrane Library were searched up to October 2006. Review methods Inclusion criteria were: randomised clinical trials; in English; full publications; subjects were adults with low back pain; one group received specific stabilisation exercises as the primary intervention; and outcome measures included some measure of pain and/or function. Following a systematic search of major databases, articles were scored according to the PEDro criteria for quality. Due to heterogeneity of specific interventions, control groups, duration of follow-up, outcome measures and study population, a meta-analysis was not conducted. A qualitative review was undertaken that focused on study quality, study population and type of control group. Results In total, 18 trials were included in the review; a large number of trials were excluded. There was little evidence to support the use of stabilisation exercises for acute low back pain. There was some evidence to support the use of stabilisation exercises in chronic back pain, with the majority of high-quality trials showing a significant difference in favour of stabilisation exercises. Overall, however, the evidence was conflicting, and significant differences favouring stabilisation exercises were less likely when they were compared with active treatment control groups rather than inactive control groups. Conclusions There may be a role for specific stabilisation exercises in some patients with chronic low back pain, but these are no more effective than other active interventions. © 2007 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.