Perturbation Training for Nonspecific Low Back Pain: A Randomized Controlled Trial
Bibliographic record
Abstract
Context Trunk-stabilization exercises, especially when performed under unstable conditions, may be beneficial for low back pain (LBP) and related symptoms. However, more evidence is needed to determine whether adding a perturbation component to the training program contributes to greater improvement. Objective To determine the effects of perturbation training on trunk-muscle endurance, disability, pain, functional mobility, quality of life, fear-avoidance beliefs, and satisfaction in patients with nonspecific LBP. Design Randomized controlled clinical trial. Setting Physiotherapy laboratory. Patients or Other Participants A total of 44 patients with nonspecific LBP (30 women, 14 men; age = 33.06 ± 9.55 years) who had pain for at least 3 months (pain duration = 3.02 ± 3.25 years) was randomly assigned to either the exercise group (EG) or the perturbation group (PG). Interventions The EG received a 2-phase trunk-based exercise program, and the PG received a 4-phase training program with perturbations added to the exercises performed by the EG. All interventions were performed 2 days per week for 8 weeks. Main Outcome Measure(s) Trunk endurance (McGill endurance tests) and LBP-related disability (Oswestry Disability Index) were the primary outcome measures. Pain intensity (visual analog scale), functional mobility (timed up-and-go test), quality of life (Short Form 12), fear-avoidance attitudes (Fear-Avoidance Beliefs Questionnaire), and patient satisfaction (Global Rating of Change) were the secondary outcome measures. Results Both groups showed improvement in all variables ( P < .05). However, the PG was superior to the EG in improving trunk-muscle endurance (flexor: F 1,41 = 12.24, P = .001; extensor: F 1,41 = 17.67, P < .001; right lateral flexor: F 1,41 = 12.93, P = .001; left lateral flexor: F 1,41 = 15.02, P < .001) and the Oswestry Disability Index ( P = .005). Between-groups effect sizes were large (partial η 2 range, 0.18–0.30). The timed up-and-go test ( F 1,41 = 4.96, P = .03) and Fear-Avoidance Beliefs Questionnaire total score improved more in the PG ( F 1,41 = 5.06, P = .03), with a medium effect size (partial η 2 = 0.11), and satisfaction was also higher in the PG ( = 4.46, P = .03). Conclusions An 8-week trunk-based exercise program, when combined with perturbation training, led to greater improvements in trunk-muscle endurance, function, total fear-avoidance belief scores, and satisfaction.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".