Treatment targets of exercise for persistent non-specific low back pain: a consensus study
Lianne Wood1, Annette Bishop2, Martyn Lewis2
1Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Faculty of Medicine and Health Sciences, Keele University, Newcastle-under-Lyme ST5 5BG, UK; Nottingham University Hospitals NHS Trust, Queens Medical Centre, Derby Road, Nottingham NG 2UH, UK.
Physiotherapy
|May 24, 2021
Summary
Consensus was reached on key exercise targets for persistent non-specific low back pain (NSLBP). Prioritized goals include improving function, quality of life, reducing pain, and addressing fear of movement in NSLBP management.
Area of Science:
- Rehabilitation Medicine
- Clinical Exercise Physiology
- Pain Management
Background:
- Persistent non-specific low back pain (NSLBP) affects millions globally, with exercise being a primary intervention.
- Despite numerous randomized controlled trials (RCTs), the specific treatment targets for exercise in NSLBP remain incompletely defined.
- A clear consensus on exercise targets is crucial for optimizing treatment efficacy and guiding future research.
Purpose of the Study:
- To establish expert consensus on the primary treatment targets for exercise interventions in persistent NSLBP.
- To identify and prioritize key outcomes that exercise should aim to achieve for individuals with NSLBP.
Main Methods:
- Modified nominal group technique employed across two sequential workshops (national and international).
- Participants included individuals with NSLBP, clinicians, and researchers involved in exercise interventions for NSLBP.
- A systematic review informed initial target generation, followed by online voting and ranking to achieve consensus (75% threshold).
Main Results:
- Thirty-nine experts contributed, generating 40 potential exercise targets.
- Twenty-five targets were retained after consensus processes.
- The top-prioritized exercise targets for persistent NSLBP were: improving function, enhancing quality of life, reducing pain, achieving patient-specific goals, and decreasing fear of movement.
Conclusions:
- Future randomized controlled trials (RCTs) for exercise in NSLBP should explicitly state their intervention targets.
- Recommended RCTs assess the identified prioritized targets and incorporate mediation analyses to understand treatment mechanisms.
- This consensus provides a framework for future research and clinical practice in exercise for persistent NSLBP.
