Study design: A systematic review of clinical trials.
Objective: To determine the effectiveness of therapeutic exercise in the treatment of instability-related lumbar spine pain.
Background: Segmental instability of the lumbar spine contributes to the overwhelming incidence of back pain and disability. The extensive range of exercises proposed to treat segmental instability is indicative of the lack of agreement as to the most efficacious management approach.
Methods: A search of MEDLINE (1966- April 2002), the Cumulative Index of Nursing and Allied Health Literature (CINAHL) (1982- April 2002) databases was performed. The searches were restricted to articles that used human subjects and were published in English. Key words utilized for searches included, "lumbar stability", "segmental instability of the lumbar spine", "spinal stability", "low back exercises", and "treatment of lumbar instability". The aforementioned key words were combined with "clinical trial" in an attempt to locate studies that were primary sources and included original data.
Results: The clinical trials analyzed varied considerably in the type of therapeutic exercise evaluated. However, it has been demonstrated that therapeutic exercise can be beneficial in reducing pain and improving function in patients presenting with instability-related lumbar spine pain.
Conclusion: Although the reviewed clinical trials have demonstrated the effectiveness of therapeutic exercise in ameliorating pain and disability, the variations in methodologies of the studies reviewed makes it difficult to speculate which specific exercises would be the most beneficial.