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Here’s the big question: what exercise works best?
Let me just tell you up front that there is nothing more annoying than research that doesn’t confirm my biases.
I know, I know. You might find the next few studies annoying BUT how boring would this update be if I just told you to activate your core?
Kind of lame, right?
So here are 4 studies that might tickle a few feathers (pretty sure I got that saying wrong).
2012 RCT by Shnayderman & Katz-Leurer looked at 52 subjects:
Question: Are specific lower back pain exercises more effective than walking on the treadmill?
Finding: After a 6 week comparison, both were effective with no significant differences between groups.
2013 study by Marshall et al. looked at 64 patients:
Question: Is an 8 week Pilates program better than stationary cycling?
Finding: At 6 month follow up, both reduced pain but there was no long term difference between groups.
2014 systematic review by Smith et al. looked at 29 studies:
Question: Are stabilisation exercises effective? If so, are they more effective than any other exercise?
Finding: Yes, core stability exercises reduced lower back pain. However, “when compared with alternative forms of exercise, there was no statistical or clinically significant difference.“
2012 meta-analysis by Wang et al. looked at 414 subjects:
Question: Are core stability exercises more effective than general exercises?
Finding: Both 6 month and 12 month follow ups found no significant differences.
Here’s the thing, though.
You definitely didn’t study for 3 - 5 years just to tell a patient that it doesn’t matter what they do.
It is far more nuanced than that.
1) Core exercises seem to help but are not necessarily superior. Exercises that are easy to do and that they enjoy are far more likely to actually get done.
2) Get your patients moving to reduce stiffness, improve variability of movement and reduce kinesiophobia.
3) And as always, use your own clinical judgment and reasoning (obviously).
References
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Written by Kyle van Heerden
Online Educator at Research Raconteur
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