The role of an integrated back stability program in patients with chronic low back pain.

STUDY DESIGN A controlled clinical trial. OBJECTIVES To assess the effects of an integrated back stability (IBS) programme on a chronic low back pain (CLBP) population in a time restricted private clinic environment. BACKGROUND Studies assessing stability training CLBP have reported inconsistent results. Methods used within trials vary, with some authors focusing on muscle isolation and others using whole body movements. IBS uses an exercise progression beginning with posturally based exercise and progressing from muscle isolation through to complex movements. METHODS AND MEASURES Fifty-nine chronic low back patients were divided into control (n=32) and intervention (n=27) groups. Participants in the intervention group were prescribed a 6 week individualized exercise programme in three stages. In stage 1, exercises addressed posture and movement dysfunction and activated the core stabilizing muscles. In stage 2, 'back fitness' was enhanced using progressive exercise principles. Stage 3 emphasized technique specific actions. Participants in the control group received a backcare advice leaflet only. RESULTS Pre- and post-test scores were analysed for each of the outcome measures within the control group using a Wilcoxin signed ranks test. At an alpha level of p<or=0.0071, no differences were observed. For the intervention group, a Mann-Whitney U-test showed significant differences between groups in the Roland and Morris Disability Questionaire (RMDQ), short form McGill Pain Questionnaire (SF-MPQ), and the Tampa Scale of Kinesiophobia (TSK) (p<or=0.0071). Patient satisfaction was assessed by questionnaire, 89% of patients considering their level of pain and functional impairment acceptable following the programme. CONCLUSION IBS significantly reduced pain and disability in the subject group studied. Patients reported a positive experience of the programme.