The article that I would like to present today raises a question that everyone that deals with back pain as a physiotherapist or even as a patient asked himself at some point : we know that exercises are good for low back pain but, Does it Matter Which Exercise?
This is not the newest research out there, However the methodology of this research is excellent and the sample size includes more than 300 patients worldwide, It is a very simple, elegant and clear research and here is a short description of it:
The clinical question was: “will there be a difference in clinical outcome of patients if we will give them a specific exercise designed for them or it will be just as good as general exercises”. The patients went through a Mechanical Diagnosis and Treatment physiotherapy evaluation (MDT or “McKenzie method”) that tried to establish whether the patients had a directional preference (DP- more on that in the next blog) and If yes what is it (Flexion, extension or Lateral movement).
After this evaluation the patients were divided into 3 different groups:
- Group A : Matched Direction – patients got as an exercise the same movement that seemed to be beneficial on the initial evaluation.
- Group B : Opposite direction- the name makes it clear, i.e patient that seemed to respond to extension positively got the opposite movement.
- Group 3, control : Evidence- based group – these patients got a non-specific exercise program in multiple directions.
I am sure you are all curious about the results – All the groups improved somewhat in all the measurements: Back and/or leg pain intensity, functional questionnaire ( Roland-Morris DQ), Pills per day for Low Back Pain and so on.
However, the improvement in the Matched Direction group was much more significant (P values <0.001) in all measurement (see graphs bellow ).
So, to answer our question, Does it Matter which exercise? Most definitely yes , and you got the proof..
Author
-
We are physiotherapists passionate about movement and rehabilitation, with a clear goal: helping people better understand their pain and return to an active, unrestricted life.
Through our practice and content, we share practical, science-based approaches to prevent injuries, relieve pain, and sustainably improve mobility. We believe that well-informed patients make better decisions and achieve better outcomes.
Richard Bouzaglou, B.Sc. PT
Physiotherapist | Co-Founder
An experienced professional, Richard is the co-founder of the AMS Medical and Rehabilitation Center, where he has played a key role since 2008. With a background in sports medicine and physiotherapy, he has developed strong clinical expertise, particularly working with elite athletes.
His practice is based on a comprehensive approach that integrates advanced manual therapy, functional rehabilitation, and personalized care. Committed to continuous education and mentoring students, he is known for his clinical rigor and his ability to build lasting, trust-based relationships with his patients.
Moshe Vazana
Physiotherapist
With over 15 years of experience, Moshe is recognized for his precise, evidence-based approach. A physiotherapy graduate with advanced training in several methodologies, including the McKenzie Method (MDT) and the Mulligan Concept, he specializes in treating musculoskeletal and spinal conditions.
His international background and commitment to excellence enable him to provide care that is tailored, effective, and sustainable. Passionate about knowledge sharing, he is also actively involved in training the next generation of physiotherapy professionals.
Does medicare cover your service
The medical visits are covered by RAMQ but all services such as physiotherapy, acupuncture, etc are private services that may be covered by your personal insurance, CNESST or SAAQ.