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Efficacy of specific skilled motor versus general exercise training on muscle and neural alterations in recurrent low back pain : protocol of a randomized clinical trial

Sophie Van Oosterwijck (UGent) , Jaap Wijnen (UGent) , Michiel Brandt (UGent) , Amber Billens (UGent) , Hannes Meirezonne (UGent) , Evy Dhondt, Lisa Bernaers (UGent) , Indra De Greef (UGent) , Ben Jeurissen, Tine Willems (UGent) , et al.
(2026) PERCEPTUAL AND MOTOR SKILLS.
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Abstract
Background: Structural and functional alterations of the brain and paravertebral muscles have been suggested as underlying mechanisms for the recurrence of non-specific low back pain (LBP). Although exercise therapy is recommended as the treatment of choice, the most effective type and mechanisms underlying its observed effects remain unclear. This study will examine the effects of skilled motor training versus general exercise training on muscle and neural alterations. Methods: In this double-blind randomized controlled clinical trial, 42 people in remission from recurrent LBP and with a flexion motor control impairment pattern will be randomly allocated to a 13-week exercise program with 18 sessions of skilled motor training or general exercise training. Outcomes related to brain structure (gray and white matter micro- and macro-structure), brain function (resting state functional connectivity), paravertebral muscle structure (cross-sectional area, muscle fat index), paravertebral muscle function (metabolic muscle function), lumbopelvic sensorimotor control, pain sensitivity, pain modulation, psychosocial factors, self-reported pain, LBP-related disability and LBP recurrence will be assessed at baseline, mid-way (after 9 sessions), at completion (after 18 sessions) and at 3-month follow-up. Selected outcomes will be reassessed at 1, 2, 6, and 9-month follow-up. Discussion: Findings may provide novel insights to guide treatment for recurrent LBP. Registered at ClinicalTrials.gov (https://clinicaltrials.gov): NCT05706103
Keywords
electromyography, exercise therapy, motor control, magnetic resonance imaging, quantitative sensory testing, rehabilitation, low back pain, CROSS-SECTIONAL AREA, SITTING POSTURES, ABNORMALITIES, REMISSION, FLEXION, PEOPLE, BRAIN, COORDINATION, METAANALYSIS, RELIABILITY

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Citation

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MLA
Van Oosterwijck, Sophie, et al. “Efficacy of Specific Skilled Motor versus General Exercise Training on Muscle and Neural Alterations in Recurrent Low Back Pain : Protocol of a Randomized Clinical Trial.” PERCEPTUAL AND MOTOR SKILLS, 2026, doi:10.1177/00315125261441406.
APA
Van Oosterwijck, S., Wijnen, J., Brandt, M., Billens, A., Meirezonne, H., Dhondt, E., … Danneels, L. (2026). Efficacy of specific skilled motor versus general exercise training on muscle and neural alterations in recurrent low back pain : protocol of a randomized clinical trial. PERCEPTUAL AND MOTOR SKILLS. https://doi.org/10.1177/00315125261441406
Chicago author-date
Van Oosterwijck, Sophie, Jaap Wijnen, Michiel Brandt, Amber Billens, Hannes Meirezonne, Evy Dhondt, Lisa Bernaers, et al. 2026. “Efficacy of Specific Skilled Motor versus General Exercise Training on Muscle and Neural Alterations in Recurrent Low Back Pain : Protocol of a Randomized Clinical Trial.” PERCEPTUAL AND MOTOR SKILLS. https://doi.org/10.1177/00315125261441406.
Chicago author-date (all authors)
Van Oosterwijck, Sophie, Jaap Wijnen, Michiel Brandt, Amber Billens, Hannes Meirezonne, Evy Dhondt, Lisa Bernaers, Indra De Greef, Ben Jeurissen, Tine Willems, Thomas Matheve, Matthijs Moerkerke, Paul Hodges, Jessica Van Oosterwijck, and Lieven Danneels. 2026. “Efficacy of Specific Skilled Motor versus General Exercise Training on Muscle and Neural Alterations in Recurrent Low Back Pain : Protocol of a Randomized Clinical Trial.” PERCEPTUAL AND MOTOR SKILLS. doi:10.1177/00315125261441406.
Vancouver
1.
Van Oosterwijck S, Wijnen J, Brandt M, Billens A, Meirezonne H, Dhondt E, et al. Efficacy of specific skilled motor versus general exercise training on muscle and neural alterations in recurrent low back pain : protocol of a randomized clinical trial. PERCEPTUAL AND MOTOR SKILLS. 2026;
IEEE
[1]
S. Van Oosterwijck et al., “Efficacy of specific skilled motor versus general exercise training on muscle and neural alterations in recurrent low back pain : protocol of a randomized clinical trial,” PERCEPTUAL AND MOTOR SKILLS, 2026.
@article{01KMP1KBSVKP7D1P47850C6SFE,
  abstract     = {{Background: Structural and functional alterations of the brain and paravertebral muscles have been suggested as underlying mechanisms for the recurrence of non-specific low back pain (LBP). Although exercise therapy is recommended as the treatment of choice, the most effective type and mechanisms underlying its observed effects remain unclear. This study will examine the effects of skilled motor training versus general exercise training on muscle and neural alterations.
Methods: In this double-blind randomized controlled clinical trial, 42 people in remission from recurrent LBP and with a flexion motor control impairment pattern will be randomly allocated to a 13-week exercise program with 18 sessions of skilled motor training or general exercise training. Outcomes related to brain structure (gray and white matter micro- and macro-structure), brain function (resting state functional connectivity), paravertebral muscle structure (cross-sectional area, muscle fat index), paravertebral muscle function (metabolic muscle function), lumbopelvic sensorimotor control, pain sensitivity, pain modulation, psychosocial factors, self-reported pain, LBP-related disability and LBP recurrence will be assessed at baseline, mid-way (after 9 sessions), at completion (after 18 sessions) and at 3-month follow-up. Selected outcomes will be reassessed at 1, 2, 6, and 9-month follow-up.
Discussion: Findings may provide novel insights to guide treatment for recurrent LBP. 
Registered at ClinicalTrials.gov (https://clinicaltrials.gov): NCT05706103}},
  author       = {{Van Oosterwijck, Sophie and Wijnen, Jaap and Brandt, Michiel and Billens, Amber and Meirezonne, Hannes and Dhondt, Evy and Bernaers, Lisa and De Greef, Indra and Jeurissen, Ben and Willems, Tine and Matheve, Thomas and Moerkerke, Matthijs and Hodges, Paul and Van Oosterwijck, Jessica and Danneels, Lieven}},
  issn         = {{0031-5125}},
  journal      = {{PERCEPTUAL AND MOTOR SKILLS}},
  keywords     = {{electromyography,exercise therapy,motor control,magnetic resonance imaging,quantitative sensory testing,rehabilitation,low back pain,CROSS-SECTIONAL AREA,SITTING POSTURES,ABNORMALITIES,REMISSION,FLEXION,PEOPLE,BRAIN,COORDINATION,METAANALYSIS,RELIABILITY}},
  language     = {{eng}},
  pages        = {{26}},
  title        = {{Efficacy of specific skilled motor versus general exercise training on muscle and neural alterations in recurrent low back pain : protocol of a randomized clinical trial}},
  url          = {{http://doi.org/10.1177/00315125261441406}},
  year         = {{2026}},
}
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