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Utilizing Clinical Practice Guidelines for Treatment of Low Back Pain: Summary
INTERVENTIONS
Exercise Terminology Table Term Definition
1. Exercise The McKenzie Method of Mechanical Diagnosis and Therapy (MDT): • Evidence-based protocol that can be applied to spine and extremities—acute, subacute and chronic • Individualized program of exercises based on clinical clues observed during assessment • Often mistaken as an “extension-based program” Williams Exercises: • Promote lumbar flexion and strengthening of abdominals and gluteals • Series of exercises: Pelvic tilt, single knee to chest motion, double knee to chest motion, partial sit up, hamstring stretch, hip flexor stretch, and squat Interventions for acute LPB without leg pain: • Specific trunk muscle activation • Note: Weak evidence (C) Interventions for acute LPB with leg pain: • Trunk muscle strengthening
Trunk muscle strengthening and endurance exercise Specific trunk muscle activation exercises
To restore or improve the strength, endurance, or power of trunk muscles or muscle groups To target specific deep trunk muscles (e.g., transversus
abdominis, multifidus) using co-contraction to alter or restore control or coordination of the lumbopelvic region
Movement control exercise
• To alter, restore, or retrain control of functional movements and tasks, with feedback on movement patterns ○ Movement control exercises often involve
activation of weak trunk musculature and inhibition of overactive muscles to restore efficiency and
coordination and include functional movements/ tasks General exercise To restore or improve overall
• Specific trunk muscle activation • Note: Moderate evidence (B)
Interventions for chronic LBP: • Trunk muscle strengthening • Trunk muscle endurance • Specific trunk muscle activation exercise
strength or endurance of the major muscle groups of the upper/lower extremities and trunk, including exercises for flexibility/mobility and aerobic/conditioning exercises
• Aerobic exercise • Aquatic exercise • General exercise
• Note: Strong evidence (A) Movement Control Exercise: • Note: Strong evidence (A) Exercise Guidelines for Older Adults (65+ years): • WHO´s Global Recommendations on Physical Activity for Health • Older adults: 150 min of moderate or 75 min vigorous intensity aerobic activity weekly
Trunk mobility exercise direction to achieve a reduction of symptoms Aerobic exercise To restore or enhance the capacity or efficiency of the cardiovascular system Multimodal exercise Combines two or more of the interventions described previously
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