Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review

BMC Musculoskeletal Disorders

Eling D de Bruin⁴  Zorica Suica¹  Brigitte Wirth²  Corina Schuster-Amft³  Michael A McCaskey² 

[1] Research Department, Reha Rheinfelden, Salinenstrasse 98, 4310 Rheinfelden, Switzerland;Department of Health Sciences and Technology, ETH Zurich, Wolfgang-Pauli Str. 27, 8093 Zurich, Switzerland;Institute of Rehabilitation and performance Technology, Bern University of Applied Sciences, Pestalozzistrasse 20, 3400 Burgdorf, Switzerland;Centre for Evidence Based Physiotherapy, Maastricht University, PO Box 616, 6200 Maastricht, MD, The Netherlands

关键词: Systematic review;    Proprioceptive training;    Neck pain;    Low back pain;    Proprioception;   

Others  :  1091853
DOI  :  10.1186/1471-2474-15-382

 received in 2014-09-24, accepted in 2014-11-06,  发布年份 2014

【 摘 要 】

Background

Proprioceptive training (PrT) is popularly applied as preventive or rehabilitative exercise method in various sports and rehabilitation settings. Its effect on pain and function is only poorly evaluated. The aim of this systematic review was to summarise and analyse the existing data on the effects of PrT on pain alleviation and functional restoration in patients with chronic (≥3 months) neck- or back pain.

Methods

Relevant electronic databases were searched from their respective inception to February 2014. Randomised controlled trials comparing PrT with conventional therapies or inactive controls in patients with neck- or low back pain were included. Two review authors independently screened articles and assessed risk of bias (RoB). Data extraction was performed by the first author and crosschecked by a second author. Quality of findings was assessed and rated according to GRADE guidelines. Pain and functional status outcomes were extracted and synthesised qualitatively and quantitatively.

Results

In total, 18 studies involving 1380 subjects described interventions related to PrT (years 1994–2013). 6 studies focussed on neck-, 12 on low back pain. Three main directions of PrT were identified: Discriminatory perceptive exercises with somatosensory stimuli to the back (pPrT, n = 2), multimodal exercises on labile surfaces (mPrT, n = 13), or joint repositioning exercise with head-eye coordination (rPrT, n = 3). Comparators entailed usual care, home based training, educational therapy, strengthening, stretching and endurance training, or inactive controls. Quality of studies was low and RoB was deemed moderate to high with a high prevalence of unclear sequence generation and group allocation (>60%). Low quality evidence suggests PrT may be more effective than not intervening at all. Low quality evidence suggests that PrT is no more effective than conventional physiotherapy. Low quality evidence suggests PrT is inferior to educational and behavioural approaches.

Conclusions

There are few relevant good quality studies on proprioceptive exercises. A descriptive summary of the evidence suggests that there is no consistent benefit in adding PrT to neck- and low back pain rehabilitation and functional restoration.

【 授权许可】

   
2014 McCaskey et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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