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Predicting a beneficial response to motor control training in patients with low back pain: a longitudinal cohort study

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Abstract

Purpose

Exercise therapy such as motor control training (MCT) has been shown to reduce pain and disability in people with low back pain (LBP). It is unknown which patients are most likely to benefit. This longitudinal cohort study aimed to: (1) retrospectively examine records from a large cohort of patients who received MCT treatment, (2) identify potentially important predictors of response to MCT and (3) test the predictors on an independent (split) sample derived from the original cohort of patients, using one group to identify the predictors and the other to test them.

Methods

The response of 775 patients with LBP to MCT was classified as ‘improved’ or ‘not improved’ based on self-reported change in pain levels and symptoms. Measures were examined for associations with improvement and entered into a logistic regression model to classify patients as low, medium or high benefits of improvement with MCT. The model was tested on an independent sample.

Results

A positive response was seen in patients with: no evidence of scoliosis [OR  = 4.0, 95% CI (1.7, 9.6)], LBP without associated groin pain [OR = 2.2, 95% CI (1.0, 5.0)], LBP which was chronic recurrent in nature [OR = 3.1, 95% CI (1.8, 5.3)] and poor results on muscle testing of the multifidus muscle [OR = 2.0, 95% CI (1.1, 3.7)]. Testing on an independent sample confirmed that patients could be classified into benefit groups.

Conclusions

This study provides a first step towards assisting clinicians to select patients most likely to respond to MCT.

Graphical abstract

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Acknowledgements

This research was funded by the Queensland Health Physiotherapy Research Fellowship and Mater Research.

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Authors and Affiliations

  1. School of Allied Health Sciences, Griffith University, Nathan Campus, 170 Kessels Road, Nathan, Brisbane, QLD, 4111, Australia

    Julie A. Hides, Margot Sexton & M. Dilani Mendis

  2. Mater Back Stability Research Clinic, Mater Health, South Brisbane, QLD, 4101, Australia

    Julie A. Hides, Ellen Jang & Linda Blackwell

  3. Mater Research, The University of Queensland, Brisbane, QLD, 4101, Australia

    Michael Murphy

  4. Physiotherapy Department, Mater Health, South Brisbane, QLD, 4101, Australia

    Michael Murphy, Ellen Jang, Linda Blackwell & M. Dilani Mendis

  5. School of Dentistry, The University of Queensland, Herston, QLD, 4006, Australia

    Christopher Sexton

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  1. Julie A. Hides
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Correspondence to Julie A. Hides.

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The Mater Misericordiae Ltd Human Research Ethics Committee approved the study.

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Hides, J.A., Murphy, M., Jang, E. et al. Predicting a beneficial response to motor control training in patients with low back pain: a longitudinal cohort study. Eur Spine J 28, 2462–2469 (2019). https://doi.org/10.1007/s00586-019-06045-7

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  • DOI: https://doi.org/10.1007/s00586-019-06045-7

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