Medical Exercise Therapy For Treating Musculoskeletal Pain: A Narrative Review Of Results From Randomized Controlled Trials With A Theoretical Perspective.
H. Lorås, B. Østerås, T. A. Torstensen, H. Østerås
Published 2015 · Medicine
Download PDFAnalyze on Scholarcy
BACKGROUND AND PURPOSE The purpose of this narrative review is to present an overview and theoretical rationale of medical exercise therapy (MET) as a physiotherapeutic rehabilitation treatment for musculoskeletal pain conditions. Results from randomized controlled trials (RCTs) conducted on MET are also presented. METHODS Computerized searches for any RCTs were conducted on the MET concept in the databases PubMed, Medline, Embase and ISI Web of science up to 2013. RESULTS Overall findings from five included MET RCTs are long-term (≥1 year) reductions in pain and improved physical and functional capabilities. These results are interpreted in the context of the biopsychosocial model, advancing the view of a dynamic interaction among physiologic, psychological and social factors that influence pain modulation. DISCUSSION MET is a biopsychosocial treatment that reduces pain and improves activities of daily living in patients with a musculoskeletal pain condition. Pain modulation is a key feature of MET, and an important area for further research is to elucidate the specific mechanisms behind the treatment effects.
This paper references
Exercise therapy for bone and muscle health: an overview of systematic reviews
K. Hagen (2012)
The biopsychosocial approach to chronic pain: scientific advances and future directions.
R. Gatchel (2007)
The Dose-Response Effect of Medical Exercise Therapy on Impairment in Patients with Unilateral Longstanding Subacromial Pain
Håvard Østerås (2010)
Long-term effects of medical exercise therapy in patients with patellofemoral pain syndrome: results from a single-blinded randomized controlled trial with 12 months follow-up.
Berit Østerås (2013)
Musculoskeletal pain in Europe: the role of personal, occupational, and social risk factors.
A. Farioli (2014)
Exercise treatment for depression: efficacy and dose response.
A. Dunn (2005)
Prevalence of self reported musculoskeletal diseases is high
H. Picavet (2003)
Medical exercise therapy, and not arthroscopic surgery, resulted in decreased depression and anxiety in patients with degenerative meniscus injury.
H. Østerås (2012)
Dose-response effects of medical exercise therapy in patients with patellofemoral pain syndrome: a randomised controlled clinical trial.
B. Østerås (2013)
Low mindfulness predicts pain catastrophizing in a fear-avoidance model of chronic pain
Robert Schütze (2010)
More recent reviews show that the content and method of exercise program delivery influence treatment outcomes.
S. D. Liddle (2005)
Chronic neck pain and exercise interventions: frequency, intensity, time, and type principle.
C. O'Riordan (2014)
High-dosage medical exercise therapy in patients with long-term subacromial shoulder pain: a randomized controlled trial.
H. Østerås (2010)
Systematic Review: Strategies for Using Exercise Therapy To Improve Outcomes in Chronic Low Back Pain
J. Hayden (2005)
Lost productive time and cost due to common pain conditions in the US workforce.
W. Stewart (2003)
Biopsychosocial profiles of different pain diagnostic groups.
Skye Porter-Moffitt (2006)
High Fear-Avoiders of Physical Activity Benefit From an Exercise Program for Patients With Back Pain
J. K. Klaber Moffett (2004)
Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art
J. Vlaeyen (2000)
Musculoskeletal pain in Europe: its impact and a comparison of population and medical perceptions of treatment in eight European countries.
A. Woolf (2004)
A comparison of work absence periods and the associated costs for two different modes of exercise therapies for patients with longstanding subacromial pain
Håvard Østerås (2008)
Efficiency and Costs of Medical Exercise Therapy, Conventional Physiotherapy, and Self‐Exercise in Patients With Chronic Low Back Pain: A Pragmatic, Randomized, Single‐Blinded, Controlled Trial With 1‐Year Follow‐Up
T. A. Torstensen (1998)
Prospective study of physical activity and depressive symptoms in middle-aged women.
W. Brown (2005)
The runner's high: opioidergic mechanisms in the human brain.
H. Boecker (2008)
Fear of Pain Influences Outcomes After Exercise-induced Delayed Onset Muscle Soreness at the Shoulder
S. George (2007)
Cortical responses to pain in healthy individuals depends on pain catastrophizing
D. Seminowicz (2006)
The effect of medical exercise therapy on a patient with chronic supraspinatus tendinitis. Diagnostic ultrasound--tissue regeneration: a case study.
T. A. Torstensen (1994)
The need for a new medical model: a challenge for biomedicine
G. Engel (1977)
Patterns of multisite pain and associations with risk factors
D. Coggon (2013)
Chronic Pain and Psychopathology: Research Findings and Theoretical Considerations
J. Dersh (2002)
Self‐efficacy mediates the relation between pain‐related fear and outcome in chronic low back pain patients
S. Woby (2007)
Effects of Exercise Therapy on Endogenous Pain-relieving Peptides in Musculoskeletal Pain: A Systematic Review
J. Fuentes C (2011)
High pain ratings predict treatment failure in chronic occupational musculoskeletal disorders.
Donald D. McGeary (2006)
The centralization phenomenon and fear-avoidance beliefs as prognostic factors for acute low back pain: a preliminary investigation involving patients classified for specific exercise.
S. George (2005)
Exercise and chronic low back pain: what works?
S. D. Liddle (2004)
Is postoperative exercise therapy necessary in patients with degenerative meniscus? A randomized controlled trial with one year follow-up
H. Østerås (2012)
Effectiveness of exercise therapy: a best-evidence summary of systematic reviews.
N. Smidt (2005)
Impact of Exercise Type and Dose on Pain and Disability in Knee Osteoarthritis: A Systematic Review and Meta‐Regression Analysis of Randomized Controlled Trials
C. Juhl (2014)
Exercise-induced Pain Intensity Predicted by Pre-exercise Fear of Pain and Pain Sensitivity
M. Bishop (2011)
Medical Exercise Therapy is Effective After Arthroscopic Surgery of Degenerative Meniscus of the Knee: A Randomized Controlled Trial
Havard Osteras (2012)
This paper is referenced by
Manual therapy, exercise therapy or combined treatment in the management of adult neck pain - A systematic review and meta-analysis.
Ken Fredin (2017)
Physical Activity, Exercise, and Musculoskeletal Disorders in Sonographers
M. McDonald (2019)
Effects of medical exercise therapy in patients with hip osteoarthritis: A randomized controlled trial with six months follow-up. A pilot study.
Håvard Østerås (2017)
The Effect of Medical Exercise Therapy on Pressure Sensitivity in Patients with Knee Osteoarthritis: A Cohort Pilot Study
Håvard Østerås (2019)
The Association Between Musculoskeletal Symptoms and Traditional Chinese Medicine Use Among Chinese Older Adults in the Greater Chicago Area
Xinqi Dong (2018)
An Up-to-Date Review of the Meniscus Literature: A Systematic Summary of Systematic Reviews and Meta-analyses
Jason B. Smoak (2020)
Use of Core Stabilization Exercise and Medical Exercise Therapy in the Treatment of a Patient with Chronic Post Partum Low Back Pain: A Case Report
Zachary Chaloner (2015)
How does exercise dose affect patients with long-term osteoarthritis of the knee? A study protocol of a randomised controlled trial in Sweden and Norway: the SWENOR Study
T. A. Torstensen (2018)