TY - JOUR
T1 - Convergence and divergence of exercise-based approaches that incorporate motor control for the management of low back pain
AU - Hides, Julie A.
AU - Donelson, Ronald
AU - Lee, Diane
AU - Prather, Heidi
AU - Sahrmann, Shirley A.
AU - Hodges, Paul W.
N1 - Funding Information:
body of research was based, “State-of-the-Art in Motor Control and Low Back Pain: International Clinical and Research Expert Forum,” was supported by the National Health and Medical Research Council of Australia, in collaboration with the North American Spine Society. The forum was chaired by Dr Paul Hodges.
Funding Information:
1School of Allied Health Sciences, Griffith University, Nathan, Australia. 2Mater Back Stability Research Clinic, Mater Health Services, South Brisbane, Australia. 3Menzies Health Institute Queensland, Gold Coast campus Griffith University, Queensland, Australia. 4SelfCare First, LLC, Hanover, NH. 5Diane Lee & Associates, Surrey, Canada. 6Departments of Orthopaedic Surgery and Neurology, Washington University School of Medicine, St Louis, MO. 7Program in Physical Therapy, Washington University School of Medicine, St Louis, MO. 8Clinical Centre for Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia. Dr Hides receives book royalties from Elsevier. She has been reimbursed by professional scientific bodies and sporting bodies for travel costs related to presenting research on motor control training and low back pain at meetings, scientific conferences, and symposia, and has received fees for teaching practical courses on motor control training. She has received industry funding from the Lions Football Club (Brisbane, Australia) and research funding from the Health Innovation, Investment and Research Office (Office of the Director-General, Department of Health, Queensland Health, Brisbane, Australia). Dr Donelson has received travel expenses and speaker’s fees for presentations at medical conferences and webinars, and book royalties from SelfCare First, LLC. Ms Lee receives book royalties from Elsevier and Handspring Publishing. She also receives fees for teaching online and in-class practical classes on the integrated systems model. She has also received travel funding and speaking fees for presenting at conferences, on the national and international levels, on the integrated systems model as well as diastasis rectus abdominis. She has received funding from the Clinical Centre for Research Excellence in Spinal Pain, Injury and Health for research into diastasis rectus abdominis. Dr Prather has received travel expenses and speaker’s fees for presentations at medical conferences, paid directly to Washington University School of Medicine. Dr Sahrmann receives book royalties from Elsevier. She receives honoraria, and her travel costs are reimbursed for teaching continuing education programs. Dr Hodges receives book royalties from Elsevier. Professional and scientific bodies have reimbursed him for travel costs related to presentation of research on pain, motor control, and exercise therapy at scientific conferences/symposia. He has received fees for teaching practical courses on motor control training. He is also supported by a Senior Principal Research Fellowship from the National Health and Medical Research Council of Australia (APP1102905). The authors certify that they have no affiliations with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the article. Address correspondence to Dr Julie A. Hides, School of Allied Health Sciences, Griffith University, Nathan Campus, 170 Kessels Road, Nathan, QLD 4111 Australia. E-mail: [email protected] U Copyright ©2019 Journal of Orthopaedic & Sports Physical Therapy®
Publisher Copyright:
Copyright © 2019 Journal of Orthopaedic & Sports Physical Therapy®
PY - 2019/6
Y1 - 2019/6
N2 - Many approaches for low back pain (LBP) management focus on modifying motor control, which refers to motor, sensory, and central processes for control of posture and movement. A common assumption across approaches is that the way an individual loads the spine by typical postures, movements, and muscle activation strategies contributes to LBP symptom onset, persistence, and recovery. However, there are also divergent features from one approach to another. This commentary presents key principles of 4 clinical physical therapy approaches, including how each incorporates motor control in LBP management, the convergence and divergence of these approaches, and how they interface with medical LBP management. The approaches considered are movement system impairment syndromes of the lumbar spine, Mechanical Diagnosis and Therapy, motor control training, and the integrated systems model. These were selected to represent the diversity of applications, including approaches using motor control as a central or an adjunct feature, and approaches that are evidence based or evidence informed. This identification of areas of convergence and divergence of approaches is designed to clarify the key aspects of each approach and thereby serve as a guide for the clinician and to provide a platform for considering a hybrid approach tailored to the individual patient.
AB - Many approaches for low back pain (LBP) management focus on modifying motor control, which refers to motor, sensory, and central processes for control of posture and movement. A common assumption across approaches is that the way an individual loads the spine by typical postures, movements, and muscle activation strategies contributes to LBP symptom onset, persistence, and recovery. However, there are also divergent features from one approach to another. This commentary presents key principles of 4 clinical physical therapy approaches, including how each incorporates motor control in LBP management, the convergence and divergence of these approaches, and how they interface with medical LBP management. The approaches considered are movement system impairment syndromes of the lumbar spine, Mechanical Diagnosis and Therapy, motor control training, and the integrated systems model. These were selected to represent the diversity of applications, including approaches using motor control as a central or an adjunct feature, and approaches that are evidence based or evidence informed. This identification of areas of convergence and divergence of approaches is designed to clarify the key aspects of each approach and thereby serve as a guide for the clinician and to provide a platform for considering a hybrid approach tailored to the individual patient.
KW - Clinical perspectives
KW - Low back pain
KW - Motor control
KW - Spinal control
UR - http://www.scopus.com/inward/record.url?scp=85066423972&partnerID=8YFLogxK
U2 - 10.2519/jospt.2019.8451
DO - 10.2519/jospt.2019.8451
M3 - Review article
C2 - 31092126
AN - SCOPUS:85066423972
SN - 0190-6011
VL - 49
SP - 437
EP - 452
JO - Journal of Orthopaedic and Sports Physical Therapy
JF - Journal of Orthopaedic and Sports Physical Therapy
IS - 6
ER -