Regional manual therapy and motor control exercise for LBP
Within the umbrella term of 'non-specific low back pain' (NSLBP), studies are being performed to identify subgroups with definable movement impairments or pain.
The inclusion and exclusion criteria are tightly monitored to filter in a specific homogeneous subgroup for the treatment to be applied on.
In this particular study, additional manual therapy to the thoracic spine, pelvis and hips (on top of local manual therapy to the lumbar spine) was shown to have short term benefits for a subgroup of patients with NSLBP.
The study defined the following subgroup of NSLBP: participants were 18-65 years of age, had NSLBP for at least 3 months, demonstrated at least 1 level of hypomobility in the thoracic or lumbar spine, had limited hip ROM deficits and demonstrated 1 level of hypermobility in the lumbar spine or reduced trunk/ pelvic muscle strength and endurance.
20 participants were included in each of the 2 groups. Both groups underwent treatment which included 10 minutes of local lumbar spine manual therapy and 20 minutes of graded motor control exercises. The intervention group received extra manual therapy in the thoracic, pelvic and hip joint regions. All participants received 2 treatments per week for 4 weeks.
When added to local manual therapy to the lumbar spine, regional manual therapy applied to the thoracic spine, pelvis, and hips resulted in additional short-term benefits regarding disability level, pain intensity, fear avoidance beliefs of work and physical activity.
> From: Zafereo et al., J Man Manip Ther (2018) (Epub ahead of print). All rights reserved to Taylor & Francis Group. Click here for the online summary.