Abstract
STUDY DESIGN: Randomized controlled trial. PURPOSE: To contrast the efficacy of two exercise programs-multifidus retraining program (MRP) and traditional back exercises (TBE)-on pain and functional disability in individuals with chronic low back pain. OVERVIEW OF LITERATURE: Low back pain is a common musculoskeletal disorder. Mechanical low back pain does not involve nerve roots. Stability of the spine is provided by the ligaments and muscles of the lower back and abdomen. Although weakness of the superficial trunk and abdominal muscles are the primary risk factors, recent studies have demonstrated the involvement of weakness and lack of control of the deep trunk muscles, especially the multifidus and transverse abdominis muscles. Therefore, exercises to restore optimal lumbar multifidus function are important in rehabilitation strategies. METHODS: Thirty individuals were randomly assigned to receive TBE, where exercises focused on the superficial muscles of abdomen and low back (control, group A) and MRP, where exercises focused on the deep multifidus muscles fibers (experimental, group B). Groups were examined to find the effect of these exercises on visual analog scale rated pain (visual analogical scale) and functional disability assessed by the Oswestry disability questionnaire. The exercise program lasted for 6 weeks on alternate days, with 20 repetitions of each exercise, with each move held for 5-8 seconds. Subjects were evaluated at the start of the study and after completion of the 6-week exercise program. RESULTS: As compared to baseline, both treatments were effective in relieving pain and improving disability (p<0.001). The MRP group had significant gains for pain and functional disability when compared to the TBE group (both p<0.001). CONCLUSIONS: Both techniques lessen pain and reduce disability. MRP is superior to TBE in reducing pain and improving function.