Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;27(1):5-14.
doi: 10.1080/10669817.2018.1532693. Epub 2018 Oct 17.

Are movement-based classification systems more effective than therapeutic exercise or guideline based care in improving outcomes for patients with chronic low back pain? A systematic review

Sean P Riley  1 , Brian T Swanson  2 , Elizabeth Dyer  2
Affiliations

Are movement-based classification systems more effective than therapeutic exercise or guideline based care in improving outcomes for patients with chronic low back pain? A systematic review

Sean P Riley et al. J Man Manip Ther. 2019 Feb.

Abstract

Objectives: The purpose of this systematic review was to determine if movement-based classification (MBC) systems are more effective than therapeutic exercise or guideline-based care (GBC) in improving outcomes in patients with low back pain (LBP) based upon randomized clinical trials (RCT) with moderate to high methodological quality and low to moderate risk of bias. Methods: The search strategy was developed by a librarian experienced in systematic review methodology and peer reviewed by a second research librarian. The following databases were searched from their inception to May 17, 2018: PubMed, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform. The identified RCTs with a PEDro score of ≥6 were screened and assessed for risk of bias by two blinded individual reviewers using Covidence. Results: Seven studies were identified that had moderate-to-high methodological quality. One of the studies was identified as having a high risk of bias. Of the six studies that remained, only one study reported finding a statistically significant difference at the immediate follow-up that was not clinically significant. There was no significance at 6 and 12 months. Discussion: There is a paucity of moderate to high methodological quality RCTs with similar methodology that compare MBC to standard of care treatments for patients with LBP. Studies with moderate to high methodological quality that have a low risk of bias do not support MBCs as being superior to general exercise or GBC in the treatment of nonradicular LBP. Level of Evidence: 1a.

Keywords: Exercise; low back pain; physical therapy; randomized controlled trials.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
(PRISMA) flow diagram.
See this image and copyright information in PMC

References

    1. Deyo RA, Mirza SK, Martin BI.. Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002. Spine (Phila Pa 1976). 2006November1;31(23):2724–2727. PubMed PMID: 17077742. - PubMed
    1. Abraham P, Rennert RC, Martin JR, et al. The role of surgery for treatment of low back pain: insights from the randomized controlled spine patient outcomes research trials. Surg Neurol Int. 2016;7:38 PubMed PMID: 27127703; PubMed Central PMCID: PMCPMC4838923. - PMC - PubMed
    1. Katz JN.Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg Am. 2006April;88(Suppl 2):21–24. PubMed PMID: 16595438. - PubMed
    1. Gugliotta M, Da Costa BR, Dabis E, et al. Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. BMJ Open. 2016December21;6(12):e012938 PubMed PMID: 28003290; PubMed Central PMCID: PMCPMC5223716. - PMC - PubMed
    1. Falla D, Hodges PW. Individualized exercise interventions for spinal pain. Exerc Sport Sci Rev. 2017April;45(2):105–115. PubMed PMID: 28092298. - PubMed

Publication types