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Table 4 Description of the included systematic reviews; number of original studies included, population, intervention and control. Motor Control Exercises (MCE)

From: Summarizing the effects of different exercise types in chronic low back pain – a systematic review of systematic reviews

Authors (year)

Number of RCT’s included in systematic review (SR) /meta-analyses (MA)

Population

Number of subjects, definition of LBP, pain

duration, % women, age

Intervention

Descriptive

Control

Descriptive

Byström et al. (2013) [48]

SR: 16

MA: 16

Number of subjects: 1768

Definition: At least 80% of the participants should have chronic or recurrent LBP. Included some subacute patients with average duration exceeded 6 mo

Duration: ≥ 12 wks

% Women: NR

Age: at least 16 yrs

MCE exercises described as “abdominal hollowing” or “abdominal draw-in” or if it was stated that the initial stage aimed to isolate isometric contraction of the TrA and/or the ME

Training period: mean 8.2 (SD 1.8) wks (calculated from the tables), mean 11.3 (SD 4.0) sessions (calculated from the tables)

General Exercise (GE)

Spinal Manual Therapy (SMT)

Minimal Intervention (MI): no intervention, advice/education or placebo treatment

Multimodal Physical Therapy (MM-PT)

Multimodal intervention vs other components of that intervention (OM)

Training period: GE: Mean 7.5 (0.9) wks

SMT: Mean 7.0 (2.3) wks

MI: Mean 9.0 (1.4) wks

MPT: poorly reported

OM: 10.0 (2.8) wks (Calculated from the tables)

Elbayomy et al. (2018) [51]

SR: 34

MA: 34

Number of subjects: 2514

Definition: Adult patients with chronic nonspecific LBP

Duration: ≥ 12 wks

% Women: NR

Age: NR

Core strengthening as dynamic stabilization, motor control (neuromuscular) training, neutral spine control and trunk stabilization

Training period: 4–12 wks, 2–4 times

per wk

General exercises (GE)

Multimodal physical therapy (MM-PT)

Manual therapy (MT)

Minimal interventions (MI): NR

Training period: NR

Ferreira et al. (2006) [49]

SR: 12

MA: 12

Number of subjects: Number of participants not reported. 965

Definition: Adults with symptoms in the cervical, thoracic, low back, or pelvic area. Symptoms could be referred to the arms (from cervical and thoracic spine) or to the legs (from lumbar spine or pelvis). Subacute /recurrent (n = 8) chronic > 12 wks (n = 5)

Duration: NR

% Women: NR

Age: Adults

Specific stabilization exercise described activating, training, or restoring the stabilization function of specific muscles of the spine and pelvis such as deep neck flexors, multifidus, transversus abdominis, diaphragm, or pelvic floor muscles. Specific stabilization exercise could be administered in isolation or in conjunction with other therapies

Training period: 3–20 wks, 1–3 times/wk

Surgery, conventional physiotherapy: NR, manual therapy. general exercises

Training period: NR

Gomes-Neto et al. (2017) [52]

SR: 11

MA: 11

Number of subjects: 1014

Definition: Chronic non-specific LBP > 3 mo w/o leg pain

Duration: NR

% Women: NR

Age: NR

Stabilization exercises was considered as prescribed exercises aimed at improving function of specific trunk muscles that control inter-segmental movement of the spine, including the transversus abdominis, multifidus, diaphragm, and pelvic floor muscles

Training period: 4–36 wks, 1–3 times/wk. 20–60 min, progressive nature of the program

GE was prescribed exercises that included strengthening and/or stretching exercises for the main muscle groups of the body as well as exercises for cardiovascular fitness. MT comprised physiotherapy based on joint mobilization or manipulation techniques

Training period: NR

Henao & Bedoya (2016) [40]

SR: 6

MA: 0

Number of subjects: 663

Definition: Duration: ≥ 3 mo

% Women: NR

Age: NR

Core exercise

Training period: 4-8wks, daily-3times/w, 40–60 min/session

GE (aerobe and strength training), minimal intervention: NR, no physical exercises

Training period: 4-8wks

Luomajoki et al. (2018) [53]

SR: 11

MA: 11

Number of subjects: 781

Definition: Subacute LBP, chronic LBP or pain more than 6 wks

Duration: No restrictions in terms of pain duration

% Women: NR

Age: NR

MVCE (more than 50%)

To change movement behavior, through a combination of physical and cognitive learning processes

Training period: 4–12 wks, one study = 1 yr

Other active interventions (n = 9); focus on function and performance of individual muscles. No intervention (n = 2)

Training period: NR

Macedo et al. (2009) [54]

SR:14

MA: 14

Number of subjects: 1696

Definition: Persistent, Nonspecific LBP (with or without leg pain) for at least 6 wks

Duration: 6 wks to 1 yrs

% Women: Studies evaluating individuals of all age groups of either sex were included. NR

Age: 16–80 yrs

Motor control specific spinal stabilization or core exercise. Exercise targeting specific trunk muscles to improve control and coordination of the spine and pelvic

Training period: 4–12 wks, 1–3 sessions/wk. (4–60 sessions in total), 30–90 min/sessions

Home exercises/home program

Training period: NR

Niederer & Mueller (2020) [55]

SR: 10

MA: 10

Number of subjects: 1081

Definition: Non-acute (sub-acute or chronic > 6 wks of duration at the time of study inclusion) non-specific low back pain. Nonspecific chronic low back pain

Duration: subacute chronic nonspecific low back pain = 6 wks (n = 1), = 8 wks (n = 1), 12 wks (n = 7), non-specified (n = 1)

% Women: 62%

Age: Mean (SD) = 43.4 yrs (11.1) (calculated from the tables)

Motor control core-specific sensorimotor / neuromuscular / sensorimotor / perturbation / core stability stabilization / stabilization exercises/training interventions with a defined completion time

Training period: mean 5.8 wks 6 of 10 studies = 8 wks (calculated from the tables), 1–12 times/wk. mean 5.5 times/wk., mean 53 min, range 30–90 min

Active or Passive (compared to an inactive or passive control group or compared to other exercises). Inactive control (n = 1), Passive treatment (n = 2), Other exercise (n = 7), pain management, daily walks

Training period: mean 5.8 wks, 6 of 10 studies = 8 wks (calculated from the tables). 30 min walk every day (1 study). NR (9 studies)

Saragiotto et al. (2016) [16]

SR: 29

MA: 29

Number of subjects: 2431

Definition: chronic (> 12 wks) non-specific LBP (with or without leg pain) or recurrent LBP. > 75% should have chronic LBP

Duration: ≥ 12 wks

% Women: NR

Age: NR

Motor Control Exercises

Training period: 20 days-12wks, (median (IQR) = 8 (2.0) wks), with a median of 12 sessions (IQR: 6.0), 1–5 times/wk

"Other types of exercises (n = 16), MI (n = 7), MT (n = 5), Exercise and electrophysical agents (n = 3) Telerehabilitation based on home exercises (n = 1)

Training period: Other exercise: 8wks (n = 8), 6wks (n = 3), 10 wks (n = 1) 4 wks (n = 1), N.R. n = 3) mean = MI: 12 wks (n = 1), poorly reported, MT: 6–8 wks, N.R. (1 study) Exercise and EPA: mean 6.3 wks (8 + 7 + 4), Telerehabilitation: 6 wks

Smith et al. (2014) [56]

SR: 29

MA: 29

Number of subjects: 2258

Definition: Non-specific LBP of any time. Low back pain defined as, but not restrictive to pain and /or stiffness between the lower rib and buttock crease with or without leg pain

Duration: 10 studies inclusive patients > 3 mo, 2 studies > 2mo, several not specified

% Women: NR

Age: NR

Stabilization, or “core stability”, exercises defined as facilitation of deep muscles of the spine (primarily transversus abdominis or multifidus) at low level, integrated into exercise, progression into functional activity

Training period: 4 to 8 wks, 1–3 sessions /wk., 20–60 min/session. 20–90 min (median (IQR) = 45 (30) min)

General Exercise (GE)

Spinal Manual Therapy (SMT)

Minimal Intervention (MI): educational booklet

Multimodal Physical Therapy (MM-PT)

Other components of MMI (OM)

Training period:

"Other exercise: 1–1,5x/wk. (n = 3), 1x/wk./45 min (n = 1), 2x/wk. (n = 1), 2x/wk./20–60 min (n = 4), 3x/wk./60 min (n = 1), 5x/wk./30 min (n = 1), 12 × 60 min (n = 1), 45 min (n = 1), N.R. (n = 3)

MI: max 12 sessions (n = 1), poorly reported

MT: 1x/wk. or max 10–12 Exercise EPA: sessions, 12x/30 min, 20 × 30 min, 35 × 40 min

Telerehabiltation: 1x/day, phone calls 2x/wks

Wang et al. (2012) [57]

SR: 5

MA: 4

Number of subjects: 494

Definition: Chronic LBP (longer than 3 mo)

Duration: ≥ 3 mo

% Women: NR

Age: NR

Core stability training is described as the reinforcement of the ability to insure stability of the neutral spine position. Core stability exercises were usually performed on labile devices, such as an air-filled disc, a low-density mat, a wobble board, or a Swiss ball

Training period: 12 sessions over 8 wks, 1 session/wk for 8 wks, 1 session/wk for 8 wks, 2 sessions/wk for 6 wks, 1 session/wk for 8 wks

GE; strengthening, stretch and aerobic exercises, trunk strengthening and stretching, exercises, superficial strengthening exercises (n = 15), trunk strengthening and stretching exercises, physical exercises (n = 40)

Training period:12 treatment sessions over 8 wk, 1 session/wk for 8 wk over 8 wks, 1 session/wk for 8 wks, 2 sessions/wk for 6 wks, 1 session/wk for 8 wks

Zhang et al. (2021) [58]

SR: 18

MA: 18

Number of subjects: 1098

Definition: Non-specific chronic low back pain (NSCLBP)

Duration: Pain duration or recurrence more than

 ≥ 12wks

Women: 42%

Age: 23–55 yrs

MCE (e.g., trunk stability exercise, core stability exercises, stabilization exercise, perturbation-based therapy) that target specific trunk muscles to improve control of the spine and pelvic

Length of session: 25–90 min

Number of intervention sessions: 4–24

Training period:1–13 wks. 1–3 sessions/wks

Sham treatment/placebo treatment (minimal intervention such as no intervention), hands-on therapies (spinal manipulative therapy/manual therapy) and other hands-off therapies (other exercises). As yoga, graded activity, gyrotonic expansion exercise, global exercise, general exercise/conventional physiotherapy, sling exercise, McKenzie exercise

Training period: same as intervention

  1. Abbreviations: EPA Electrophysical Agents, GE General exercises, LBP Low Back Pain, MCE Motor Control Exercises, MI Minimal Intervention, min Minutes, MMI MultiModal Intervention, MM-PT Multimodal Physiotherapy, mo Months, MT Spinal Manual Therapy, NR Not reported, OM Other components of Multimodal Intervention, SD Standard deviation, VAS Visual Analogue Scale, wks Weeks, yrs Years