Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of
Angela Searle1, Martin Spink2, Alan Ho3
1Discipline of Podiatry, University of Newcastle, NSW, Australia Angela.Searle@newcastle.edu.au.
Objective:
To determine, for adults with chronic low back pain, which exercise interventions are the most effective at reducing pain compared to other treatments.
Data Sources:
A search of MEDLINE, CINAHL, EMBASE, SPORTDiscus, PsycINFO and The Cochrane Library was conducted up to October 2014.
Review Methods:
Databases were searched for published reports of randomised trials that investigated the treatment of chronic low back pain of non-specific origin with an exercise intervention. Two authors independently reviewed and selected relevant trials. Methodological quality was evaluated using the Downs and Black tool.
Results:
Forty-five trials met the inclusion criteria and thirty-nine were included in the meta-analysis. Combined meta-analysis revealed significantly lower chronic low back pain with intervention groups using exercise compared to a control group or other treatment group (Standard Mean Deviation (SMD) =-0.32, CI 95% -0.44 to -0.19, P<0.01). Separate exploratory subgroup analysis showed a significant effect for strength/resistance and coordination/stabilisation programs.
Conclusions:
Our results found a beneficial effect for strength/resistance and coordination/stabilisation exercise programs over other interventions in the treatment of chronic low back pain and that cardiorespiratory and combined exercise programs are ineffective.
