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Cited by 69Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyPregnancy-related medical research

Motor control or graded activity exercises for chronic low back pain? A randomised controlled trial

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Macedo, Luciana G, Latimer, Jane, Maher, Chris G, Hodges, Paul W, Nicholas, Michael, Tonkin, Lois, McAuley, James H, Stafford, Ryan·2008·BMC Musculoskeletal Disorders
DOI 10.1186/1471-2474-9-65PMC PMC2409320
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Abstract

BACKGROUND: Chronic low back pain remains a major health problem in Australia and around the world. Unfortunately the majority of treatments for this condition produce small effects because not all patients respond to each treatment. It appears that only 25-50% of patients respond to exercise. The two most popular types of exercise for low back pain are graded activity and motor control exercises. At present however, there are no guidelines to help clinicians select the best treatment for a patient. As a result, time and money are wasted on treatments which ultimately fail to help the patient. METHODS: This paper describes the protocol of a randomised clinical trial comparing the effects of motor control exercises with a graded activity program in the treatment of chronic non specific low back pain. Further analysis will identify clinical features that may predict a patient's response to each treatment. One hundred and seventy two participants will be randomly allocated to receive either a program of motor control exercises or graded activity. Measures of outcome will be obtained at 2, 6 and 12 months after randomisation. The primary outcomes are: pain (average pain intensity over the last week) and function (patient-specific functional scale) at 2 and 6 months. Potential treatment effect modifiers will be measured at baseline. DISCUSSION: This trial will not only evaluate which exercise approach is more effective in general for patients will chronic low back pain, but will also determine which exercise approach is best for an individual patient. TRIAL REGISTRATION NUMBER: ACTRN12607000432415.

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  • Individuals who make more effort to stop and remove pain or use distracting strategies for avoiding pain experience more pain and psychological distress than individuals who face and accept their pain-related feelings, emotions, and thoughts.

    “Evidences show that individuals who make more effort to stop and remove pain or use distracting strategies for avoiding pain experience more pain and psychological distress in comparison to individuals who face their feelings, emotions, and thoughts related to pain and accept them (Macedo, Latimer, Maher, Hodges, Nicholas, Tonkin, McAuley, & Stafford, 2008).”

    From The effectiveness of group acceptance and commitment therapy on pain intensity, pain catastrophizing and pain-associated anxiety in patients with chronic pain (2015) · cites this paper as Macedo, Latimer, Maher, Hodges, Nicholas, Tonkin, McAuley, & Stafford, 2008

    The Treatment effect modifiers section discusses unhelpful beliefs about back pain and plans to measure pain anxiety and self-efficacy. The Interventions section describes graded activity and addressing fear of injury. Neither section compares pain avoidance or distraction with acceptance of pain-related thoughts and feelings, or reports that one group experiences more pain and psychological distress; searches for those concepts found no supporting passage. Page numbers were not provided in our copy. (LLM, conf=0.76)

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Authors
Macedo, L. G., Latimer, J., Maher, C. G., Hodges, P. W., Nicholas, M., Tonkin, L., McAuley, J. H., & Stafford, R.
Affiliations
  • The George Institute for Global Health (AU)
  • The University of Queensland (AU)
  • The University of Sydney (AU)
Corresponding author
Macedo, Luciana G
ORCID
Venue
BMC Musculoskeletal Disorders
Publisher
Springer Science and Business Media LLC
Published
2008-05-05
Volume
9
Issue
1
Pages
65-65
ISSN
1471-2474 (ISSN-L)
DOI
10.1186/1471-2474-9-65
PMC
PMC2409320
OpenAlex
W2008292722
Cited by
69
References
5
Citations by year
2026: 1 · 2025: 3 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 8 · 2019: 1 · 2018: 1 · 2017: 3 · 2016: 8 · 2015: 5 · 2014: 4 · 2013: 3 · 2012: 8
FWCI
3.32
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Musculoskeletal Disorders (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Australian Government
  • University of Sydney
  • Medical Research Council
  • National Health and Medical Research Council
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
Keywords
chronic low back pain, non-specific low back pain, motor control exercises, graded activity, exercise therapy, treatment response prediction, pain intensity, functional capacity, Patient-Specific Functional Scale, treatment effect modifiers
MeSH terms
Chronic Disease, Exercise Therapy, Follow-Up Studies, Humans, Motor Skills, Research Design, Low Back Pain, Patient Selection

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