A meta-analysis of randomized, controlled trials was used to determine the short-term, intermediate, and long-term effectiveness of MCE, with regard to pain and disability, in patients with chronic and recurrent low-back pain using. In the past, meta-analyses have shown no difference between the effects of MCE and general exercise in the treatment of low back pain. Several high quality studies on this subject have been published recently, warranting a new meta-analysis. The study’s authors searched electronic databases up to October 2011 for randomised controlled trials clearly distinguishing MCE from other treatments. They extracted pain and disability outcomes and converted them to a 0 to 100 scale. They used the RevMan5 (Nordic Cochrane Centre, Copenhagen, Denmark) software to perform pooled analyses to determine the weighted mean differences (WMDs) between MCE and 5 different control interventions. Sixteen studies were included. The pooled results favored MCE compared with general exercise as far as disability during all time periods, and with regard to pain in the short and intermediate term. Compared with spinal manual therapy, MCE was better with regard to disability during all time periods, but not with regard to pain. What’s more, MCE was superior to minimal intervention during all time periods with regard to both pain and disability.
The authors found that in patients with chronic and recurrent low back pain, MCE seem to be more effective than several other treatments. They stressed, however, that more studies are needed to investigate what subgroups of patients experiencing LBP respond best to MCE.