The Effect of Adding Lumbar Extension Strengthening to a Program of Manual Therapy & Motor Control Exercise in Individuals With Chronic Low Back Pain: A Randomized Control Trial

Summary

The goal of this clinical trial is to determine the effect of adding lumbar strengthening exercises to a program of manual therapy and motor control exercises (standard therapy) in adults with chronic low back pain (cLBP). Researchers will compare individuals with cLBP that receive lumbar extensor strengthening in addition to standard therapy compared to standard therapy alone to determine if there are differences in patient reported outcomes, lumbar multifidus thickness, low back endurance, and healthcare utilization between the groups. All participants will engage in 8-weeks of physical therapy, receiving manual therapy and motor control exercises. Those in the intervention group will have additional low back strengthening exercises.

Description

Eligibility

Age range

18–65 years

Sex

All

Healthy volunteers

No

Interventions

• Other
  Standard Physical Therapy

  Participants randomized to the SPT group (control group) will receive pragmatic treatments of manual therapy and motor control exercises (MCE) based on their clinical presentation, which is consistent with standard patient care management of chronic lower back pain. They will attend a total of 10-14 visits over a course of 8 weeks, as is typical for routine care of individuals with cLBP. The treating physical therapist will use manual therapy and motor control exercise interventions that will be tailored to the patient's individual presentation.

• Other
  Lumbar Extensor Strengthening plus Standard Physical Therapy

  Participants randomized to the SPT+LEX group (experimental group) will receive the same pragmatic treatments of manual therapy and MCE as the control group over the same number of visits (10-14). In addition to MCE and manual therapy, this group will perform specific lumbar extensor strengthening. These exercises target the lumbar extensor muscle group (to include the lumbar multifidus) and may be performed by lying prone on the edge of a bench or mat and lifting the legs to parallel while the torso is stabilized. Alternatively, they may be performed by stabilizing the hips and legs while lifting the torso to varying angles from horizontal with or without weights.

Location