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Background. Treatment for chronic low back pain (LBP) includes different forms of exercises, that to date have resulted in only small to moderate treatment effects. To enhance the treatment effects, different classification systems have been developed to classify people with LBP into more homogeneous subgroups leading to specific treatments for each subgroup. Objective. The purpose of this study was to compare the efficacy of a treatment based on the Movement System Impairment (MSI) model with a treatment consisting of symptom- guided stretching and strengthening exercises in people with chronic LBP. Design. The study was a 2-arm, prospectively registered, randomized controlled trial with a blinded assessor. Setting. The study setting was a university physical therapy clinic in Brazil. Patients. A total of 148 participants with chronic LBP participated in the study. Interventions. Participants were randomly allocated to an 8-week treatment of either treatment based on the MSI-based classification system or symptom-guided stretching and strengthening exercises. Measurements. Measures of pain intensity, disability, and global impression of recovery were obtained by a blinded assessor at baseline and at follow-up appointments at 2, 4, and 6 months after randomization. Results. There were no significant between-group differences for the primary outcomes of pain intensity at 2 months (mean difference = 0.05, 95% CI = -0.90 to 0.80) and disability at 2 months (mean difference = 0.00, 95% CI = -1.55 to 1.56). There also were no statistically significant differences between treatment groups for any of the secondary outcome measures. Limitations. Participants and physical therapists were not masked. Conclusions. People with chronic LBP had similar improvements in pain, disability, and global impression of recovery with treatment consisting of symptom-guided stretching and strengthening exercises and treatment based on the MSI model. [ABSTRACT FROM AUTHOR]

* STUDY DESIGN: Cross-sectional, case-control design. * BACKGROUND: Pelvic movement has been considered a possible discriminating parameter associated with femoroacetabular impingement (FAI) symptom onset. Decreased pelvic rotation has been found during squatting in people with FAI when compared to people with healthy hips. However, it is possible that changes in pelvic movement may occur in other hip conditions because of pain and may not be specific to FAI. * OBJECTIVES: To compare sagittal pelvic rotation during hip flexion and in sitting between people with FAI and people with other symptomatic hip conditions. * METHODS: Thirty people with symptomatic FAI, 30 people with other symptomatic hip conditions, and 20 people with healthy hips participated in the study. Sagittal pelvic rotation was calculated based on measures of pelvic alignment in standing, hip flexion to 45° and 90°, and sitting. * RESULTS: There were significant differences in sagittal pelvic rotation among the 3 groups in all conditions (P<.05). Post hoc analyses revealed that participants in the symptomatic FAI group had less pelvic rotation during hip flexion to 45° and 90° compared to participants in the other symptomatic hip conditions group and the hip-healthy group (mean difference, 1.2°-1.9°). In sitting, participants in the other symptomatic hip conditions group had less posterior pelvic rotation compared to those in the hip-healthy group (mean difference, 3.9°). * CONCLUSION: People with symptomatic FAI have less posterior pelvic rotation during hip flexion when compared to people with other symptomatic hip conditions and those with healthy hips. * LEVEL OF EVIDENCE: Diagnosis, level 4. [ABSTRACT FROM AUTHOR]

Background. Low back pain (LBP) is an important health problem in all developed countries and is associated with high levels of disability. Evidence-based clinical practice guidelines usually recommend different physical therapy interventions to manage this condition. However, those interventions usually result in small to moderate clinical effects. Recent studies suggest that interventions based on subgroup classifications may improve the effect sizes compared with rehabilitation programs where the same interventions were applied to all patients. Objective. This study will investigate the efficacy of treatment based on a Movement System Impairment (MSI)- based classification model for patients with chronic LBP compared with general exercise. The primary outcomes will be pain intensity and disability at 2 months after randomization. Design. The study is a 2-arm, prospectively registered, randomized controlled trial with a blinded assessor. Setting. The study setting will be a university physical therapy clinic in Brazil. Participants. A total of 148 individuals with chronic LBP will participate in the study. Intervention. Included individuals will be randomly allocated to participate in an 8-week treatment program based on the MSI-based classification or a general exercise program of stretching and strengthening exercises. Measurements. Pain intensity, disability, and global impression of recovery will be assessed by a blinded assessor at baseline and at follow-up appointments after treatment (2 months) and 4 and 6 months after randomization. Limitations. Therapists will not be blinded. Conclusions. The results of this study may contribute to a better understanding of the efficacy of treatments based on classification of participants with chronic LBP into subgroups. [ABSTRACT FROM AUTHOR]