First published on July 29, 2010
Physical Therapy
DOI: 10.2522/ptj.20090421
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Research Reports

Motor Control Exercises, Sling Exercises, and General Exercises for Patients With Chronic Low Back Pain: A Randomized Controlled Trial With 1-Year Follow-up

Monica Unsgaard-Tøndel, Anne Margrethe Fladmark, Øyvind Salvesen and Ottar Vasseljen

M. Unsgaard-Tøndel, MSc, is a PhD candidate in the Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. Mailing address: Department of Public Health and General Practice, Norwegian University of Science and Technology, Faculty of Medicine, Medisinsk Teknisk Forskningssenter, 7489 Trondheim, Norway.
A.M. Fladmark, MSc, is Research Assistant, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology.
Ø. Salvesen, MSc, is Assistant Professor, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology.
O. Vasseljen, PhD, is Associate Professor, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology.

monica.unsgaard.tondel{at}ntnu.no

Background: Exercise benefits patients with chronic nonspecific low back pain; however, the most effective type of exercise remains unknown.

Objective: This study compared outcomes after motor control exercises, sling exercises, and general exercises for low back pain.

Design: This was a randomized controlled trial with 1-year follow-up.

Setting: The study was conducted in a primary care setting in Norway.

Patients: The participants were patients with chronic nonspecific low back pain (n=109).

Interventions: The interventions in this study were low-load motor control exercises, high-load sling exercises, or general exercises, all delivered by experienced physical therapists, once a week for 8 weeks.

Measurements: The primary outcome measure was pain reported on the Numeric Pain Rating Scale after treatment and at a 1-year follow-up. Secondary outcome measures were self-reported activity limitation (assessed with the Oswestry Disability Index), clinically examined function (assessed with the Fingertip-to-Floor Test), and fear-avoidance beliefs after intervention.

Results: The postintervention assessment showed no significant differences among groups with respect to pain (overall group difference) or any of the outcome measures. Mean (95% confidence interval) group differences for pain reduction after treatment and after 1 year were 0.3 (–0.7 to 1.3) and 0.4 (–0.7 to 1.4) for motor control exercises versus sling exercises, 0.7 (–0.6 to 2.0) and 0.3 (–0.8 to 1.4) for sling exercises versus general exercises, and 1.0 (–0.1 to 2.0) and 0.7 (–0.3 to 1.7) for motor control exercises versus general exercises.

Limitations: The nature of the interventions made blinding impossible.

Conclusions: This study gave no evidence that 8 treatments with individually instructed motor control exercises or sling exercises were superior to general exercises for chronic low back pain.


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