Taxonomy and Clinical Implications of Motor Control in Musculoskeletal Low Back Pain. A Scoping Review

Autori

Federico Fiorini (University of Rome La Sapienza Department of Human Neuroscience, Rome,Italy)

Mirko Zitti (University of Rome La Sapienza Department of Human Neuroscience, Rome,Italy)

Rebecca Andreutto (University of Rome La Sapienza Department of Human Neuroscience, Rome,Italy)

Graziano Raffaele(University of Rome La Sapienza Department of Human Neuroscience, Rome,Italy)

Fabio Fiorentino(University of Rome La Sapienza Department of Human Neuroscience, Rome,Italy)

Rachele Paciotti(University of Rome La Sapienza Department of Human Neuroscience, Rome,Italy)

Lorenzo Storari(University of Rome La Sapienza Department of Human Neuroscience, Rome,Italy)

Fabiola Garzonio(University of Rome La Sapienza Department of Human Neuroscience, Rome,Italy)

Giulia Ganassin(University of Rome La Sapienza Department of Human Neuroscience, Rome,Italy)

FIlippo Maselli(University of Rome La Sapienza Department of Human Neuroscience, Rome,Italy)

Background and aims

Motor control impairments (MCI) are a clinical manifestation of musculoskeletal low back pain (MSK-LBP). However, no consensus exists on the definition of motor control (MC). Various definitions highlight neurological and musculoskeletal aspects, while the most effective strategies for managing MC impairments in MSK-LBP remain unclear.

This review aims to map different MC definitions, understand its role, and explore its influence within MSK-LBP.

Methods

A comprehensive literature search was conducted across four databases (MEDLINE, Cochrane Library, Scopus, and Web of Science) for articles published up to November 15, 2024. Eligible sources included systematic reviews, narrative reviews, randomized controlled trials, expert opinions, validation studies, editorials, and clinical commentaries. No publication date restrictions were applied.

Only articles published in English were considered for inclusion.

The drafting of the manuscript adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.

The study protocol was prospectively registered on the Open Science Framework (OSF) at OSF.IO/D4TAC

Results

A total of 3596 records were identified, of which only 26 studies met the eligibility criteria.

The most recent literature defines MC as “an area of physics exploring laws of nature defining how the nervous system interacts with other body parts and the environment to produce purposeful, coordinated actions”.

Motor control exercise has medium and long-term positive effects in the rehabilitation of musculoskeletal chronic low back pain. However, it appears to be comparable to other forms of exercise.

Conclusion

MC depends on central nervous system function, but its direct correlation with MSK-LBP remains unclear. Current evidence does not support MC exercises for acute or subacute MSK-LBP, potentially due to misclassification of interventions not adhering to MC principles. It remains uncertain whether MCI is a primary pain generator in MSK-LBP or a consequence of the condition.

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