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Updated: Oct 10, 2026
Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
Motivational interviewing increases physical activity for adults with low back pain: a systematic review and
Stephen Barrett1,2, Ashley R Dunford3, Tara Bewley3
1Research and Innovation, Bendigo Health, Bendigo, VIC 3552, Australia.
Background:
Low back pain (LBP) is the leading cause of disability globally and contributes substantially to healthcare costs and lost productivity. Physical activity (PA) is recommended for managing LBP, nevertheless, many individuals with LBP remain insufficiently physically active, and strategies to support behavior change are needed. Motivational interviewing (MI) may support behavior change by enhancing intrinsic motivation and self-efficacy.
Purpose:
To synthesize evidence on the effects of MI interventions targeting PA behavior in adults with LBP.
Methods:
Six databases (MEDLINE, Embase, CINAHL, Web of Science, CENTRAL, PsycINFO) and clinical trial registries were searched from inception to February 2026. Eligible trials evaluated MI-based interventions targeting PA in adults with acute, subacute, or chronic LBP. Random-effects meta-analyses were conducted to calculate standardized mean differences (SMD; Hedges' g) and 95% confidence intervals (CI). The primary outcome was change in PA; secondary outcomes included pain and disability-related outcomes. Risk of bias was assessed using the Cochrane tool, and certainty of evidence was evaluated using GRADE.
Results:
Motivational interviewing-based interventions were associated with a statistically significant increase in PA compared with control conditions (SMD: 0.57; 95% CI, 0.10-1.03; P = .02), representing a moderate effect. No statistically significant effects were observed for pain (SMD: 0.04; 95% CI, -0.27 to 0.36; P = .76) or disability (SMD: 0.08; 95% CI, -0.25 to 0.40; P = .60). Certainty of evidence was low for PA and very low for pain and disability outcomes.
Conclusions:
Motivational interviewing interventions were associated with increased PA in adults with LBP but did not demonstrate significant effects on pain or disability. MI may serve as a client-centered support strategy within broader rehabilitation models. Further high-quality trials with fidelity assessment and longer follow-up are warranted.