Practicability of segmental stabilizing exercises in the context of a group program for the secondary prevention of low back pain. An explorative pilot study.
AIM
Segmental stabilizing exercises (SSE) for specific dysfunction of local muscles (m. transversus abdominis, m. multifidus, pelvic floor muscles and diaphragm pelvis) have been advocated in patients with low back pain (LBP). The specific aims of this study were to examine: 1) whether participants of a group program learn SSE; 2) whether they respond to SSE with a reduction in present LBP and 3) to what extent people report using SSE in daily living.


METHODS
One-hundred nurses participated in this explorative pilot study. Data from a 12-week multimodal program including SSE as intervention for the prevention of LBP were analysed. The prone test was taken as an indicator for the participants' ability to perform SSE correctly. Present back pain was assessed on a numerical rating scale (0-10). A compliance questionnaire and a transfer questionnaire assessed compliance and transfer of SSE into daily living.


RESULTS
After the intervention, 72% of participants were able to perform SSE correctly as measured by the prone test. Between 48% and 78% of the participants with present LBP experienced a minimal, clinically important change (minimal clinical changes, [MCC]) while performing SSE. No strong interrelations between the ability to correctly perform SSE and the MCC of LBP could be identified. Participants reported exercising SSE for 12 min on average 4-5 days a week. At 3 months after the intervention, 76% of participants reported using SSE ''always'' in their work with patients.


CONCLUSION
First findings are that SSE can be learned by the majority of the participants of a group program for the prevention of LBP. Additionally, SSE reduces present LBP and so can help people with LBP learn to help themselves. We are unable to explain how participants benefited from SSE even when they were unable to perform SSE correctly, as measured by the prone test.