[Segmental stabilization in low back pain: a systematic review]

Abstract

Background: Segmental Stabilizing Exercises (SSE) has a strong theoretical basis in treatment and prevention of Low Back Pain (LBP). The clinical effectiveness has not been clearly established.

Study design: A systematic review of clinical- and randomized. controlled trials.

Objectives: To evaluate the effectiveness of SSE for acute, subacute, chronic and recurrent LBP.

Methods: Electronic database PubMed was searched for reviews of SSE from November 2008 to March 2009. Keywords were low back pain, lumbar stabilization, segmental stabilizing exercises, spinal stabilization exercises. For chronic LBP, four comparisons were made: Effectiveness of SSE versus minimal intervention, effectiveness of SSE as a supplement, effectiveness of SSE versus other physiotherapy treatment and effectiveness of SSE versus surgery.

Results: 17 trials were included. For acute LBP, SSE is equally effective as treatment by general practitioner in reducing short- term pain or disability. For long-term effects after an acute episode of LBP, SSE is more effective in reducing recurrence. For chronic LBP, SSE is more effective than a minimal intervention and may be as effective as other physiotherapeutic treatments in reducing pain and disability. Equal improvement in both groups was measured for surgery. There are no results concerning subacute LBP.

Conclusion: For LBP, SSE is more effective than a minimal intervention, but it is not more effective than other physiotherapy interventions.