Motor control problems in patients with spinal pain: A new direction for therapeutic exercise

Recent research into muscle dysfunction in patients with low back pain has led to discoveries of impairments in deep muscles of the trunk and back. Th ese muscles have a functional role in enhancing spinal segmental support an d control. The muscle impairments are not those of strength but rather prob lems in motor control. These findings call for a different approach in ther apeutic exercise, namely a motor learning exercise protocol. The specific e xercise approach has an initial focus on retraining the cocontraction of th e deep muscles tie, the transversus abdominis and lumbar multifidus. Initia l clinical trials point to the effectiveness of the approach in patients wi th both acute and chronic low back pain in terms of reducing the neuromuscu lar impairment and in control of pain.