Effects of Precision Rehabilitation Based on Selective Functional Movement Assessment on Pain, Multifidus Thickness, and Recurrence Rate in Patients with Chronic Non-Specific Low Back Pain: A Prospective Randomized Controlled Trial

Abstract

This trial examined how an individualized rehabilitation program based on the Selective Functional Movement Assessment (SFMA) affected pain, functional disability, multifidus morphology, and recurrence in patients with chronic non-specific low back pain (CNLBP). Sixty CNLBP patients were enrolled in a prospective randomized controlled trial and randomly assigned to a control group or an observation group. The control group received routine rehabilitation only. The observation group received routine rehabilitation plus SFMA screening, after which individualized intervention was delivered according to the abnormal movement patterns identified. At baseline, the two groups were pretty comparable—nothing much to separate them. Four weeks in, though, the observation group looked better on pain and function: VAS dropped 67.9%, and RMDQ dropped 74.2%. Both reductions were larger than in the control group (P<0.05), and the effect seemed to get stronger as treatment went on. Ultrasound findings pointed in the same direction. L4-5 multifidus thickness increased by 38.2% in the observation group, versus 27.3% in controls (P<0.05)—more or less a sign that the spinal stabilizer muscles were remodeling. At the three-month follow-up, recurrence was 6.67% in the observation group and 23.33% in controls (P<0.05), which works out to roughly a 71.4% lower recurrence risk. So SFMA-guided rehab can help spot and fix movement-pattern deficits. It gives fairly quick pain relief, improves function, and helps the multifidus thicken. Down the road, it may also lower the chance of recurrence.