***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: [ Purpose ] The purpose of this study was to examine the effects of selective exercise for the deep abdominal muscles ( SEDA ) and lumbar stabilization exercise ( LSE ) on the thickness of the transversus abdominis and postural maintenance on an unstable base of support . [ Subjects and Methods ] The subjects of this study were 20 male and 10 female adults in their 20s without lumbar pain . They were equally and r and omly assigned to a SEDA group and a LSE group . The thickness of the transversus abdominis was measured using ultrasound imaging during rest and drawing-in . The thickness of the transversus abdominis was measured when subjects raised their right and left legs while lying on a Swiss ball . [ Results ] Initially , there were no differences between the two groups . After the intervention , significant differences were observed in all parameters . A significant interaction between group and period was not found for any parameters . [ Conclusion ] In conclusion , both SEDA and LSE  thickened the transversus abdominis , which is a deep abdominal muscle , thereby adjusting posture , and stabilizing the trunk . These exercises increased the thickness of the deep abdominal muscles . They are important exercises for improving the stability of athletes or patients who need postural adjustment Study Design . A r and omized trial . Objective . To evaluate the effectiveness of a semi-intensive multidisciplinary rehabilitation for patients with chronic low back pain in an outpatient setting . Summary and Background Data . Systematic review s have shown that there is strong evidence that intensive multidisciplinary treatment ( > 100 hours ) , which includes functional restoration , improves function among chronic patients with low back pain , and moderate evidence that it reduces pain but contradictory evidence regarding improvement of working ability . However , there is paucity of data whether semi-intensive outpatient multidisciplinary rehabilitation in groups is more effective than individual physiotherapy . Material s and Methods . A total of 120 women employed as healthcare and social care professionals with nonspecific chronic low back pain were recruited from two occupational healthcare centers . The patients were r and omized into two intervention programs . Multidisciplinary rehabilitation ( n = 59 ) was conducted in groups and comprised of physical training , workplace interventions , back school , relaxation training , and cognitive-behavioral stress management methods for 70 hours . The individual physiotherapy ( n = 61 ) included physical exercise and passive treatment methods administered for 10 hours . Main outcome measures were : back pain and sciatic pain intensity , disability , sick leaves , healthcare consumption , symptoms of depression , and beliefs of working ability after 2 years . Results . There were no statistically significant differences between the two treatment groups in main outcome measures just after rehabilitation , at 6- , at 12- , or 24-month follow-up . In both intervention arms , however , the before- and -after comparison showed favorable effects , and the effects were still maintained at 2 years follow-up . Conclusions . The results of this study indicate that semilight outpatient multidisciplinary rehabilitation program for female chronic low back pain patients does not offer incremental benefits when compared with rehabilitation carried out by a physiotherapist having a cognitive-behavioral way of administering the treatment Background While one in ten Australians suffer from chronic low back pain this condition remains extremely difficult to treat . Many contemporary treatments are of unknown value . One potentially useful therapy is the use of motor control exercise . This therapy has a biologically plausible effect , is readily available in primary care and it is of modest cost . However , to date , the efficacy of motor control exercise has not been established . Methods This paper describes the protocol for a clinical trial comparing the effects of motor control exercise versus placebo in the treatment of chronic non-specific low back pain . One hundred and fifty-four participants will be r and omly allocated to receive an 8-week program of motor control exercise or placebo ( detuned short wave and detuned ultrasound ) . Measures of outcomes will be obtained at follow-up appointments at 2 , 6 and 12 months after r and omisation . The primary outcomes are : pain , global perceived effect and patient-generated measure of disability at 2 months and recurrence at 12 months . Discussion This trial will be the first placebo-controlled trial of motor control exercise . The results will inform best practice for treating chronic low back pain and prevent its occurrence STUDY DESIGN A controlled clinical trial . OBJECTIVES To assess the effects of an integrated back stability ( IBS ) programme on a chronic low back pain ( CLBP ) population in a time restricted private clinic environment . BACKGROUND Studies assessing stability training CLBP have reported inconsistent results . Methods used within trials vary , with some authors focusing on muscle isolation and others using whole body movements . IBS uses an exercise progression beginning with posturally based exercise and progressing from muscle isolation through to complex movements . METHODS AND MEASURES Fifty-nine chronic low back patients were divided into control ( n=32 ) and intervention ( n=27 ) groups . Participants in the intervention group were prescribed a 6 week individualized exercise programme in three stages . In stage 1 , exercises addressed posture and movement dysfunction and activated the core stabilizing muscles . In stage 2 , ' back fitness ' was enhanced using progressive exercise principles . Stage 3 emphasized technique specific actions . Participants in the control group received a backcare advice leaflet only . RESULTS Pre- and post-test scores were analysed for each of the outcome measures within the control group using a Wilcoxin signed ranks test . At an alpha level of p < or=0.0071 , no differences were observed . For the intervention group , a Mann-Whitney U-test showed significant differences between groups in the Rol and and Morris Disability Question aire ( RMDQ ) , short form McGill Pain Question naire ( SF-MPQ ) , and the Tampa Scale of Kinesiophobia ( TSK ) ( p < or=0.0071 ) . Patient satisfaction was assessed by question naire , 89 % of patients considering their level of pain and functional impairment acceptable following the programme . CONCLUSION IBS significantly reduced pain and disability in the subject group studied . Patients reported a positive experience of the programme Study Design . Single blind r and omized study . Objectives . To compare the effectiveness of  lumbar instrumented fusion with cognitive intervention and exercises in patients with chronic low back pain and disc degeneration . Summary of Background Data . To the authors ’ best knowledge , only one r and omized study has evaluated the effectiveness of lumbar fusion . The Swedish Lumbar Spine Study reported that lumbar fusion was better than continuing physiotherapy and care by the family physician . Patients and Methods . Sixty-four patients aged 25–60 years with low back pain lasting longer than 1 year and evidence of disc degeneration at L4–L5 and /or L5–S1 at radiographic examination were r and omized to either lumbar fusion with posterior transpedicular screws and postoperative physiotherapy , or cognitive intervention and exercises . The cognitive intervention consisted of a lecture to give the patient an underst and ing that ordinary physical activity would not harm the disc and a recommendation to use the back and bend it . This was reinforced by three daily physical exercise sessions for 3 weeks . The main outcome measure was the Oswestry Disability Index . Results . At the 1-year follow-up visit , 97 % of the patients , including 6 patients who had either not attended treatment or changed groups , were examined . The Oswestry Disability Index was significantly reduced from 41 to 26 after surgery , compared with 42 to 30 after cognitive intervention and exercises . The mean difference between groups was 2.3 ( −6.7 to 11.4 ) ( P = 0.33 ) . Improvements inback pain , use of analgesics , emotional distress , life satisfaction , and return to work were not different . Fear-avoidance beliefs and fingertip-floor distance were reduced more after nonoperative treatment , and lower limb pain was reduced more after surgery . The success rateaccording to an independent observer was 70 % after surgery and 76 % after cognitive intervention and exercises .  The early complication rate in the surgical group was 18 % . Conclusion . The main outcome measure showed equal improvement in patients with chronic low back pain and disc degeneration r and omized to cognitive intervention and exercises , or lumbar fusion Study Design . A prospect i ve r and omized controlled trial . Objectives . To examine the effectiveness of combined manipulative treatment , stabilizing exercises , and physician consultation compared with physician consultation alone for chronic low back pain . Summary of Background Data . Strong evidence exists that manual therapy provides more effective short-term pain relief than does placebo treatment in the management of chronic low back pain . The evidence for long-term effect is lacking . Methods . Two hundred four chronic low back pain patients , whose Oswestry disability index was at least 16 % , were r and omly assigned to either a manipulative-treatment group or a consultation group . All were clinical ly examined , informed about their back pain , provided with an educational booklet , and were given specific instructions based on the clinical evaluation . The treatment included four sessions of manipulation and stabilizing exercises aim ing to correct the lumbopelvic rhythm . Question naires inquired about pain intensity , self-rated disability , mental depression , health-related quality of life , health care costs , and production costs . Results . At the baseline , the groups were comparable , except for the percentage of employees ( P = 0.01 ) . At the 5- and 12-month follow-ups , the manipulative-treatment group showed more significant reductions in pain intensity ( P < 0.001 ) and in self-rated disability ( P = 0.002 ) than the consultation group . However , we detected no significant difference between the groups in health-related quality of life or in costs . Conclusions . The manipulative treatment with stabilizing exercises was more effective in reducing pain intensity and disability than the physician consultation alone . The present study showed that short , specific treatment programs with proper patient information may alter the course of chronic low back pain Background : Excessive lumbar vertebrae translation and rotation in sagittal plane has been attributed as an associated factor of lumbar segmental instability ( LSI ) and low back pain ( LBP ) . Reduction of these abnormalities improves back pain . The aim of this study was to investigate the effect of core stability exercise on the translation and rotation of lumbar vertebrae in sagittal plane in patients with nonspecific chronic LBP ( NSCLBP ) . Methods : In this r and omized clinical trial , 30 patients with NSCLBP due to LSI were included . The participants were r and omly divided into two groups of treatment and control . The treatment group received general exercises plus core stability exercise for 8 weeks whereas ; the control group received only general exercises . The magnitude of translation ( mm ) and rotation ( deg ) of lumbar vertebrae in the sagittal plane was determined by radiography in flexion and extension at baseline and after intervention . The primary outcome measures were to determine the mean changes from baseline in translation and rotation of the lumbar vertebrae in the sagittal plane after 8 weeks of intervention in each group . The secondary outcome was to compare the two groups in regard to translation and rotation of the lumbar vertebrae at the end of the study period . Data were analyzed using paired t-test and independent t-test . Results : Thirty patients aged 18 - 40 years old with clinical diagnosis of NSCLBP entered the study . Compared with baseline values , mean value of translation and rotation of the lumbar vertebra reduced significantly in both groups ( P<0.05 ) , except L3 translation in the control group . At the endpoint , mean translation value of L4 ( P=0.04 ) and L5 ( P=0.001 ) and rotation of the L5 ( P=0.01 ) in the treatment group was significantly lower than the control group . Conclusion : These findings indicate that in patients presented with NSCLBP due to lumbar segmental instability , core stability exercises plus general exercises are more efficient than general exercises alone in the improvement of excessive lumbar vertebrae translation and rotation Background The evidence that exercise intervention is effective for treatment of chronic low back pain comes from trials that are not placebo-controlled . Objective The purpose of this study was to investigate the efficacy of motor control exercise for people with chronic low back pain . Design This was a r and omized , placebo-controlled trial . Setting The study was conducted in an outpatient physical therapy department in Australia . Patients The participants were 154 patients with chronic low back pain of more than 12 weeks ’ duration . Intervention Twelve sessions of motor control exercise ( ie , exercises design ed to improve function of specific muscles of the low back region and the control of posture and movement ) or placebo ( ie , detuned ultrasound therapy and detuned short-wave therapy ) were conducted over 8 weeks . Measurements Primary outcomes were pain intensity , activity ( measured by the Patient-Specific Functional Scale ) , and patient 's global impression of recovery measured at 2 months . Secondary outcomes were pain ; activity ( measured by the Patient-Specific Functional Scale ) ; patient 's global impression of recovery measured at 6 and 12 months ; activity limitation ( measured by the Rol and -Morris Disability Question naire ) at 2 , 6 , and 12 months ; and risk of persistent or recurrent pain at 12 months . Results The exercise intervention  improved activity and patient 's global impression of recovery but did not clearly reduce pain at 2 months . The mean effect of exercise on activity ( measured by the Patient-Specific Functional Scale ) was 1.1 points ( 95 % confidence interval [CI]=0.3 to 1.8 ) , the mean effect on global impression of recovery was 1.5 points ( 95 % CI=0.4 to 2.5 ) , and the mean effect on pain was 0.9 points ( 95 % CI=−0.01 to 1.8 ) , all measured on 11-point scales . Secondary outcomes also favored motor control exercise . Limitation Clinicians could not be blinded to the intervention they provided . Conclusions Motor control exercise produced short-term improvements in global impression of recovery and activity , but not pain , for people with chronic low back pain . Most of the effects observed in the short term were 
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Finally , very low- quality evidence indicates that addition of MCE to medical management does not provide clinical ly important improvement for pain or disability at short term follow-up .
We identified only three small trials that also evaluated different comparisons ; therefore , no firm conclusions can be drawn on the effectiveness of MCE for acute LBP .
Evidence of very low to moderate quality indicates that MCE showed no benefit over  spinal manipulative therapy  , other forms of  exercise or medical treatment  in decreasing pain and disability among patients with acute and subacute low back pain .