I don’t like to use the word “stabilization” in the title but it is somewhat of a catchy term that draws eyes to the article so I figured therapists would read it. As written in prior posts and if you continue to follow this blog, you will read over and over again but bottom line is that instability is a garbage can expression. Bottom line, therapists have no valid clinical test to examine it and even if we do have radiographs of end range lumbar spine flexion and extension in front of us, this only explains end-range static osteoligamentous faults; not mid-range dynamic control.
Now back to the point of the article, there are many patients who arrive to the clinic stating they need stabilization exercises as their back “gives out” or “slips out”. This can be said of both LB & SIJ. As therapists, we usually go straight to abdominal drawing-in maneuver to contract transverse abdominus and lumbar multifidus. Our theory is that these muscles are weak and performing 25-30% MVIC will fix their pain and let them walk out the door with a smile on their face. Why do we continue to do this??!!
To date, the only articles stating that stabilization is effective is the following:
– Richardson et al (1999): only 13 subjects and did not measure LM.
– Hides et al (2001): for only acute 1st episode LBP.
– O’Sullivan (1997): Only for spondylolysis or spondylolisthesis.
– Stuge et al (2006): ALL spinal musculature is needed for best results for postpartum pelvic pain.
As evidenced-informed therapists, we should not take the stabilization route unless your patient falls under the above subgroups per up to date literature review. Although I will still refute this and you can decide yourself after referring back to another article faulting the entire TrA approach as a whole. This concept really needs to be abandoned from our thoughts as the evidence is purely lacking.
Go ahead, just throw it in the trash.
What are your thoughts on stabilization exercises for lumbopelvic disorders? Do you find it effective in your practice?