Aerobic vs. resistance exercise for chronic non-specific low back pain: A systematic review and meta-analysis

This meta-analysis compared progressive aerobic training (PAT) to progressive resistance training (PRT) for pain, disability and quality of life (QoL) in people with chronic non-specific low back pain (CNSLBP).

Five electronic databases were systematically searched up to 1 March 2016. Randomised controlled trials included land-based PAT, PRT or combined PRT and PAT, versus usual care for CNSLBP. Exercise interventions were supervised a minimum of once per week and performed ⩾ 2 days/week for ⩾ 6 weeks. Outcome measurements were pain intensity, disability, and QoL. Standardised mean difference (SMD) and mean difference (MD) were calculated using Review Manager 5.3.

Six studies were included, comprising 333 participants (94 PRT, 93 PAT, 146 usual care; 66% female; age = 44 ± 6 years; duration of pain = 7 ± 6 years). Exercise significantly reduced pain intensity (SMD =-0.42 [-0.80, -0.03]; p< 0.03) although neither mode proved superior. PRT significantly improved the Short Form Health Survey-Mental Component Score (SF-MCS) (MD = 5.74 [2.02, 9.47]; p= 0.002).

PAT and PRT decreased pain intensity in individuals with CNSLBP although neither mode was superior. Resistance exercise improved psychological wellbeing. High-quality RCTs comparing PAT, PRT, and PAT + PRT, are required.