***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: 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 maintained at the 6- and 12-month follow-ups OBJECTIVE To compare the effects of 4 months of isolated lumbar resistance exercise and total body resistance exercise on walking performance in obese , older adults with chronic low back pain . A secondary analysis examined whether responsiveness to training modulated walking improvement . DESIGN R and omized , controlled trial . SETTING Research laboratory affiliated with tertiary care facility . METHODS AND INTERVENTION Participants ( N = 49 ; 60 - 85 years ) were r and omized into a 4-month resistance exercise intervention ( TOTRX ) , lumbar extensor exercise intervention ( LEXT ) , or a control group ( CON ) . MAIN OUTCOME MEASUREMENTS Walking performance , maximal low back strength and leg strength , and average resting and low back pain severity score ( from an 11-point numerical pain rating scale ; NRSpain ) were collected at baseline and month 4 . RESULTS The TOTRX and LEXT improved lumbar extensor strength relative to CON , and the TOTRX ( P < .05 ) . NRSpain scores at month 4 were lowest in the TOTRX group compared with the LEXT and CON groups , respectively ( 2.0 ± 1.7 points vs 3.7 ± 2.6 points and 4.6 ± 2.4 points ; P < .006 ) . A total of 53 % and 67 % of participants in the TOTRX and LEXT groups were responders who made lumbar extensor strength gains that achieved ≥20 % greater than baseline values . Although the TOTRX demonstrated the greatest improvement in walking endurance among the intervention groups , this did not reach significance ( 10.1 ± 12.2 % improvement in TOTRX vs 7.4 ± 30.0 % LEXT and -1.7 ± 17.4 % CON ; P = .11 ) . Gait speed increased most in the TOTRX ( 9.0 ± 13.5 % ) compared with the LEXT and CON groups ( P < .05 ) . The change in lumbar extensor strength explained 10.6 % of the variance of the regression model for the change in walking endurance ( P = .024 ) . CONCLUSIONS The use of LEXT and TOTRX produced similar modest improvements in patients ' walking endurance . Lumbar extensor strength gain compared with leg strength gain is a moderate but important contributor to walking endurance in obese older adults with chronic low back pain . Responders to resistance exercise programs ( event those with only lumbar extension exercise ) who make at least a 20 % improvement in strength can expect better improvement in walking endurance than those who do not achieve this strength improvement Background The treatment of non-specific chronic low back pain is often based on three different models regarding the development and maintenance of pain and especially functional limitations : the deconditioning model , the cognitive behavioral model and the biopsychosocial model . There is evidence that rehabilitation of patients with chronic low back pain is more effective than no treatment , but information is lacking about the differential effectiveness of different kinds of rehabilitation . A direct comparison of a physical , a cognitive-behavioral treatment and a combination of both has never been carried out so far . Methods The effectiveness of active physical , cognitive-behavioral and combined treatment for  chronic non-specific low back pain compared with a waiting list control group was determined by performing a r and omized controlled trial in three rehabilitation centers . Two hundred and twenty three patients were r and omized , using concealed block r and omization to one of the following treatments , which they attended three times a week for 10 weeks : Active Physical Treatment ( APT ) , Cognitive-Behavioral Treatment ( CBT ) , Combined Treatment of APT and CBT ( CT ) , or Waiting List ( WL ) . The outcome variables were self-reported functional limitations , patient 's main complaints , pain , mood , self-rated treatment effectiveness , treatment satisfaction and physical performance including walking , st and ing up , reaching forward , stair climbing and lifting . Assessment s were carried out by blinded research assistants at baseline and immediately post-treatment . The data were analyzed using the intention-to-treat principle . Results For 212 patients , data were available for analysis . After treatment , significant reductions were observed in functional limitations , patient 's main complaints and pain intensity for all three active treatments compared to the WL . Also , the self-rated treatment effectiveness and satisfaction appeared to be higher in the three active treatments . Several physical performance tasks improved in APT and CT but not in CBT . No clinical ly relevant differences were found between the CT and APT , or between CT and CBT . Conclusion All three active treatments were effective in comparison to no treatment , but no clinical ly relevant differences between the combined and the single component treatments were found Objectives Although motor control exercises have been shown to be effective in the management of  low back pain ( LBP ) the mechanism of action is unclear . The current study investigated the relationship between the ability to recruit transversus abdominis and clinical outcomes of participants in a clinical trial . Methods Ultrasonography was used to assess the ability to recruit transversus abdominis in a nested design : a sample of 34 participants with chronic LBP was recruited from participants in a r and omised controlled trial comparing the efficacy of motor control exercise , general exercise and spinal manipulative therapy .  Perceived recovery , function , disability and pain were also assessed . Results Participants with chronic LBP receiving motor control exercise had a greater improvement in recruitment of transversus abdominis ( 7.8 % ) than participants receiving general exercise ( 4.9 % reduction ) or spinal manipulative therapy ( 3.7 % reduction ) . The effect of motor control exercise on pain reduction was greater in participants who had a poor ability to recruit transversus abdominis at baseline . There was a significant , moderate correlation between improved recruitment of transversus abdominis and a reduction in disability ( r = −0.35 ; 95 % CI 0.02 to 0.62 ) . Conclusion These data provide some support for the hypothesised mechanism of action of motor control exercise and suggest that the treatment may be more effective in those with a poor ability to recruit transversus abdominis OBJECTIVE To determine if the use of an isokinetic device for trunk exercise is more effective than st and ard physiotherapy in promoting motor disinhibition for patients with chronic low back pain . POPULATION chronic low back pain out patients who are treated in a Rheumatology or PM & R unit within an academic hospital . METHODOLOGY This is a prospect i ve , controlled , r and omized study , with two groups of treatment : one treated with isokinetic techniques and the other with st and ard physiotherapy , six sessions for each treatment during 2 weeks . Outcome measures include pain ( VSA ) , trunk mobility ( Schöber index , distance from fingers to floor ) , muscle extensibility and muscle strength ( Biering-Sorensen and Shirado-Ito test ) , and functional capacity ( Quebec scale ) . RESULTS Seventeen subjects were enrolled . The results suggest that both isokinetic exercise and physiotherapy result in improved range of motion , extensibility , muscle strength , and pain , without any significant superiority of one technique over the other . However , each technique has specific advantage . DISCUSSION Despite method ologic limitations , this study shows that isokinetic exercise is not better than physiotherapy in reversing motor inhibition in chronic low back pain . Our results are consistent with those of other studies in the literature , with regard to the absence of established overall superiority of one exercise technique or program over the other in this population , and with regard to partial benefits of specific exercise techniques . CONCLUSION The non-specific benefit of one technique indicates that further studies are needed to evaluate the benefit of combining exercise techniques in chronic low back pain , in order to address the multiple factors involved in this pathology Study Design . R and omized , single blind , controlled trial . Objective . To determine the efficacy of 2 components of musculoskeletal physiotherapy on chronic low back disorder . Summary of Background Data . Musculoskeletal physiotherapy encompasses many treatment methods , however , manual therapy and exercises to rehabilitate spinal stabilization are the most frequently used . Despite their popularity , scant evidence supports their use on subjects with chronic low back disorder . Methods . A total of 346 subjects were r and omized to manual therapy , a 10-week spinal stabilization rehabilitation program , or a minimal intervention control group . Data were collected at baseline , and 3 , 6 , 12 , and 24 months after intervention . Outcome measures recorded intensity of low back pain , disability , h and icap , medication , and quality of life . There were 4 main variables combined in a primary component analysis to form a single outcome measure ( i.e. , a measure of dysfunction ) . Results . The results indicated statistically significant improvements in favor of the spinal stabilization group at the 6-month stage in pain ( 65.9 % reduction in symptoms ) and dysfunction ( combined mean reduction of 134 , st and ard error 23.84 ) , and at the 1-year stage in medication ( 34.3 % reduction in medication ) , dysfunction ( combined mean reduction of 134 , st and ard error 18.2 ) , and disability ( mean difference in change 15.71 Oswestry Disability Index , 95 % confidence interval 19.3–10.01 ) . Conclusions . As a component of musculoskeletal physiotherapy , the spinal stabilization program is more effective than manually applied therapy or an education booklet in treating chronic low back disorder over time . Both manual therapy and the spinal stabilization program are significantly effective in pain reduction in comparison to an active control . To our knowledge and up until now , this result has not been shown in patients with chronic low back disorder OBJECTIVE To develop a clinical prediction rule to predict treatment response to a stabilization exercise program for patients with low back pain ( LBP ) . DESIGN A prospect i ve , cohort study of patients with nonradicular LBP referred to physical therapy ( PT ) . SETTING Outpatient PT clinics . PARTICIPANTS Fifty-four patients with nonradicular LBP . INTERVENTION A st and ardized stabilization exercise program . MAIN OUTCOME MEASURE Treatment response ( success or failure ) was categorized based on changes in the Oswestry Disability Question naire scores after 8 weeks . RESULTS Eighteen subjects were categorized as treatment successes , 15 as treatment failures , and 21 as somewhat improved . After using regression analyses to determine the association between st and ardized examination variables and treatment response status , preliminary clinical prediction rules were developed for predicting success ( positive likelihood ratio [ LR ] , 4.0 ) and failure ( negative LR , .18 ) . The most important variables were age , straight-leg raise , prone instability test , aberrant motions , lumbar hypermobility , and fear-avoidance beliefs . CONCLUSIONS It appears that the response to a stabilization exercise program in patients with LBP can be predicted from variables collected from the clinical examination . The prediction rules could be used to determine whether patients with LBP are likely to benefit from stabilization exercises The application of single motor unit biofeedback training ( SMUBT ) techniques was compared to traditional therapies in treating chronic low back pain ( CLBP ) . Thirty-six volunteers ( who experienced daily pain for 7 years in the T8 to S1 area ) were r and omly assigned to one of three treatments ; SMUBT , relaxation training , or an educational program . The pain level and electromyographic activity of all subjects were assessed by a person blind to the treatment ; before , immediately after , and 90 days after treatment . The SMUBT group reported immediately decreased pain which was maintained at 90 days , the relaxation group showed no changes , while the education group reported decreased pain at 90 days . The EMG results showed decreased amplitude and bilateral differences for the SMUBT and education groups . A 4-year follow-up revealed the SMUBT group remained symptom free . Implication s and discussion of the results concludes the paper Context Yoga combines exercise with achieving a state of mental focus through breath 
    Output:
    
Conclusions : Our results found a beneficial effect for strength/resistance and coordination/stabilisation exercise programs over other interventions in the treatment of chronic low back pain and that cardiorespiratory and combined exercise programs are ineffective