Effects of Motor Control Exercises in Patients With Chronic Nonspecific Low Back Pain: A Systematic Review and Meta-Analysis

Abstract

Objective: The primary objective of this systematic review is to assess whether motor control exercises consisting of the methodology described by Richardson and Hodges improve the pain and disability of patients with nonspecific low back pain. Design: Systematic review and a meta-analysis. Setting: A literature review was conducted using PubMed, PEDro, Scielo, CINAHL, Web of Science, Dialnet, Scopus, and MEDLINE from inception to November 2021. Patients: Patients with chronic nonspecific low back pain. Interventions: Randomized controlled trials assessing motor control exercises versus inactive control, placebo or minimal intervention, and other exercises. Main Outcome Measures: Pain intensity, disability, and physical activity were considered as primary outcomes. Results: Eighteen studies with 1356 patients were finally included in the systematic review, of which only 13 randomized clinical trials could be meta-analyzed. Statistically significant results were found in favor of the motor control group for the comparison with other exercises in disability at postintervention term (Mean Difference, 95% Confidence Interval [CI], −3.13 [−5.87 to −0.38], P = 0.03); for the comparison with inactive control, placebo, or minimal intervention in pain at postintervention term (MD, 95% CI, −18.10 [−30.79 to −5.41], P = 0.008); and for comparison with general exercises (MD, 95% CI, −12.70 [−20.80 to −4.60], P = 0.002). Conclusions: Moderate-quality evidence regarding the effectiveness of motor control exercises to reduce pain intensity and disability exists, but the reduction should be interpreted with caution.