Cited by 207Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyPregnancy-related medical research

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Exercises for prevention of recurrences of low-back pain

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Choi, Brian KL, Verbeek, Jos H, Tam, Wilson Wai-San, Jiang, Johnny Y·2010·Cochrane Database of Systematic Reviews

DOI 10.1002/14651858.cd006555.pub2PMC PMC8078403

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Abstract

BACKGROUND: Back pain is a common disorder that has a tendency to recur. It is unclear if exercises, either as part of treatment or as a post-treatment programme, can reduce back pain recurrences. OBJECTIVES: To investigate the effectiveness of exercises for preventing new episodes of low-back pain or low-back pain-associated disability. SEARCH STRATEGY: We searched CENTRAL (The Cochrane Library 2009, issue 3), MEDLINE, EMBASE and CINAHL up to July 2009. SELECTION CRITERIA: Inclusion criteria were: participants who had experienced back pain before, an intervention that consisted of exercises without additional specific treatment and outcomes that measured recurrence of back pain or time to recurrence. DATA COLLECTION AND ANALYSIS: Two review authors independently judged if references met the inclusion criteria. The same review authors independently extracted data and judged the risk of bias of the studies. Studies were divided into post-treatment intervention programmes and treatment studies. Study results were pooled with meta-analyses if participants, interventions, controls and outcomes were judged to be sufficiently homogenous. MAIN RESULTS: We included 13 articles reporting on nine studies with nine interventions. Four studies with 407 participants evaluated post-treatment programmes and five studies with 1113 participants evaluated exercise as a treatment modality. Four studies had a low risk of bias, one study a high risk and the remainder an unclear risk of bias.We found moderate quality evidence that post-treatment exercises were more effective than no intervention for reducing the rate of recurrences at one year (Rate Ratio 0.50; 95% Confidence Interval 0.34 to 0.73). There was moderate quality evidence that the number of recurrences was significantly reduced in two studies (Mean Difference -0.35; 95% CI -0.60 to -0.10) at one-half to two years follow-up. There was very low quality evidence that the days on sick leave were reduced by post-treatment exercises (Mean Difference -4.37; 95% CI -7.74 to -0.99) at one-half to two years follow-up.We found conflicting evidence for the effectiveness of exercise treatment in reducing the number of recurrences or the recurrence rate. AUTHORS' CONCLUSIONS: There is moderate quality evidence that post-treatment exercise programmes can prevent recurrences of back pain but conflicting evidence was found for treatment exercise. Studies into the validity of measurement of recurrences and the effectiveness of post-treatment exercise are needed.

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The effectiveness of two active interventions compared to self-care advice in employees with non-acute low back symptoms: a randomised, controlled trial with a 4-year follow-up in the occupational health setting
Rantonen, J., Luoto, S., Vehtari, A., Hupli, M. T., Karppinen, J. I., Malmivaara, A. V., & TAIMELA, S. P. (2011) · Occupational and Environmental Medicine · doi:10.1136/oem.2009.054312 · Cited by 24
Neuromuscular exercise and back counselling for female nursing personnel with recurrent non-specific low back pain: study protocol of a randomised controlled trial (NURSE-RCT)
Suni, J. H., Rinne, M. B., Kankaanpaa, M. J., Taulaniemi, A., Lusa, S., Lindholm, H. J., & Parkkari, J. P. (2016) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2015-000098 · Cited by 27
Preventive aspectsregarding back pain
Dorner, T. E., & Crevenna, R. (2015) · Wiener Medizinische Wochenschrift · doi:10.1007/s10354-015-0413-2 · Cited by 23
Lumbar Multifidus Muscle Thickness Does Not Predict Patients With Low Back Pain Who Improve With Trunk Stabilization Exercises
Zielinski, K. A., Henry, S. M., Ouellette-Morton, R. H., & DeSarno, M. (2012) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2012.12.001 · Cited by 22
“Subjects (1) were between 21 and 55 years old, (2) had a history of chronic LBP ( 12mo) with or without recurrences, (3) could stand and walk independently, (4) had a Modified Oswestry Low Back Pain Disability Questionnaire (OSW) score of 19%, and/or a score less than 8 on at least 1 activity from the Patient Specific…”
BackgroundMethodResultInfluential
Clinical guidelines are silent on the recommendation of physical activity and exercise therapy for low back pain: A systematic review
Comachio, J., Ferreira, M. L., Mork, P. J., Holtermann, A., Ho, E. K., Wang, D. X. M., Lan, Q., Stamatakis, E., Beckenkamp, P. R., & Ferreira, P. H. (2024) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2024.01.003 · Cited by 22
Patients' perceived needs for allied health, and complementary and alternative medicines for low back pain: A systematic scoping review
Chou, L., Ranger, T. A., Peiris, W. L., Cicuttini, F., Urquhart, D. M., Briggs, A. M., & Wluka, A. E. (2018) · Health Expectations · doi:10.1111/hex.12676 · Cited by 21
Modifiable lifestyle-related prognostic factors for the onset of chronic spinal pain: A systematic review of longitudinal studies
Manderlier, A., de Fooz, M., Patris, S., & Berquin, A. D. (2022) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2022.101660 · Cited by 19
Comparative efficacy of three active treatment modules on psychosocial variables in patients with long-term mechanical low-back pain: a randomized-controlled trial
Mbada, C. E., Ayanniyi, O., & Ogunlade, S. O. (2015) · Archives of Physiotherapy · doi:10.1186/s40945-015-0010-0 · Cited by 19
Evaluation of factors associated with severe and frequent back pain in high school athletes
Noll, M. A., Silveira, É. A., & de Avelar, I. S. (2017) · PLoS ONE · doi:10.1371/journal.pone.0171978 · Cited by 19
Feasibility and impact of sit-stand workstations with and without exercise in office workers at risk of low back pain: A pilot comparative effectiveness trial
Johnston, V., Gane, E. M., Brown, W. J., Vicenzino, B., Healy, G. N., Gilson, N. D., & Smith, M. D. (2018) · Applied Ergonomics · doi:10.1016/j.apergo.2018.12.006 · Cited by 21
Effect of Two Different Exercise Regimens on Trunk Muscle Morphometry and Endurance in Soldiers in Training
Teyhen, D. S., Childs, J. D., Dugan, J. L., Wright, A. C., Sorge, J. A., Mello, J. L., Marmolejo, M. G., Taylor, A. Y., Wu, S. S., & George, S. Z. (2012) · Physical Therapy · doi:10.2522/ptj.20120152 · Cited by 19
Effect of a 6-month sedentary behavior reduction intervention on well-being and workplace health in desk workers with low back pain
Hergenroeder, A., Quinn, T. D., Perdomo, S. J., Kline, C. E., & Gibbs, B. B. (2022) · Work · doi:10.3233/wor-205178 · Cited by 18
Effect of Comorbid Knee and Hip Osteoarthritis on Longitudinal Clinical and Health Care Use Outcomes in Older Adults With New Visits for Back Pain
Rundell, S. D., Goode, A. P., Suri, P., Heagerty, P. J., Comstock, B. A., Friedly, J. L., Gold, L. S., Bauer, Z., Avins, A. L., Nedeljković, S. S., et al. (2016) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2016.06.022 · Cited by 18
Machine learning-based identification of determinants for rehabilitation success and future healthcare use prevention in patients with high-grade, chronic, nonspecific low back pain: an individual data 7-year follow-up analysis on 154,167 individuals
Niederer, D., Schiller, J., Groneberg, D. A., Behringer, M., Wolfarth, B., & Gabrys, L. (2023) · Pain · doi:10.1097/j.pain.0000000000003087 · Cited by 21
Issues of comorbidity in clinical guidelines and systematic reviews from a rehabilitation perspective
Meyer, T., & Wulff, K. (2019) · European Journal of Physical and Rehabilitation Medicine · doi:10.23736/s1973-9087.19.05786-1 · Cited by 20
Early occupational intervention for people with low back pain in physically demanding jobs: A randomized clinical trial
Hansen, B. B., Kirkeskov, L., Begtrup, L. M., Boesen, M., Bliddal, H., Christensen, R., Andreasen, D. L., Kristensen, L. E., Flachs, E. M., & Kryger, A. I. (2019) · PLoS Medicine · doi:10.1371/journal.pmed.1002898 · Cited by 16
Effectiveness of a standardised exercise programme for recurrent neck and low back pain: a multicentre, randomised, two-arm, parallel group trial across 34 fitness clubs in Finland
Suni, J. H., Rinne, M. B., Tokola, K., Mänttäri, A., & Vasankari, T. J. (2017) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2017-000233 · Cited by 24
Low Back Pain—A Disease or Condition of Impaired Functional Health? Definition-Inherent Consequences for the Comprehensive Care of Back Pain Patients
Ammer, K., EBENBICHLER, G. R., & Bochdansky, T. (2022) · BioMed · doi:10.3390/biomed2020022 · Cited by 14
A Guide to Exercise Prescription
Crookham, J. (2013) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2013.08.002 · Cited by 17
Nonspecific Low Back Pain
Passalent, L., Inman, R. D., & Haroon, N. (2022) · New England Journal of Medicine · doi:10.1056/nejmc2207597 · Cited by 16
Effects of lumbar-pelvic training combined with electroacupuncture on chronic nonspecific low back pain
Cheng, Y., Yu, Y., Wang, Y., Fan, A., Yang, H., Wang, H., & Tang, L.-G. (2023) · Medicine · doi:10.1097/md.0000000000034407 · Cited by 13
General Practitioners' recommendations of self-directed-exercises for musculoskeletal problems and perceived barriers and facilitators to doing so: a mixed methods study
Gillman, T., Schmidtke, K. A., Manning, V., & Vlaev, I. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3799-x · Cited by 13
“The Cochrane reviews on exercise in knee [24] and hip [25] osteoarthritis and meta-analyses of exercises for tendinopathy [26] and back pain [27]”
Background
Acute effects of game-based biofeedback training on trunk motion in chronic low back pain: a randomized cross-over pilot trial
Mueller, J., Niederer, D., Tenberg, S., Oberheim, L., Moesner, A., & Mueller, S. (2022) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-022-00586-z · Cited by 13
Effect of Six-Week Resistance and Sensorimotor Training on Trunk Strength and Stability in Elite Adolescent Athletes: A Randomized Controlled Pilot Trial
Mueller, S., Mueller, J., Stoll, J., & Mayer, F. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.802315 · Cited by 12
Movement control impairment as a sub-group of non-specific low back pain : evaluation of movement control test battery as a practical tool in the diagnosis of movement control impairment and treatment of this dysfunction
Luomajoki, H. A. (2010) · UEF eRepo (University of Eastern Finland) · Cited by 11
Physiotherapists’ barriers and facilitators to the implementation of a behaviour change-informed exercise intervention to promote the adoption of regular exercise practice in patients at risk of recurrence of low back pain: a qualitative study
Moniz, A., Duarte, S. T., Aguiar, P. M. V., Caeiro, C., Pires, D., Fernandes, R. S., Moço, D., Marques, M. M., de Sousa, R. D., Canhão, H. M., et al. (2024) · BMC Family Practice · doi:10.1186/s12875-024-02274-y · Cited by 14
Back to living well: community-based management of low back pain: a feasibility study
Macedo, L. G., Richardson, J. A., Battié, M. C., Hancock, M. J., KWAN, M. Y. W., Hladysh, G., & Zhuo, L. X. (2021) · Pilot and Feasibility Studies · doi:10.1186/s40814-021-00863-7 · Cited by 10
Schmerzmechanismen und Clinical Reasoning
Luomajoki, H. A., & Schesser, R. (2018) · Der Schmerzpatient · doi:10.1055/s-0043-122097 · Cited by 10
“[4] Choi BK1, Verbeek JH, Tam WW et al.”
Background
Evidence-based physiotherapy
Bender, T. (2013) · Orvosi Hetilap · doi:10.1556/oh.2013.29758 · Cited by 9
An overview of conservative treatment for lower back pain
Balagué, F., & Dudler, J. (2011) · International Journal of Clinical Rheumatology · doi:10.2217/ijr.11.13 · Cited by 11
How effective are allied health group interventions for the management of adults with long-term conditions? An umbrella review of systematic reviews and its applicability to the Australian primary health system
Dennis, S. M., Kwok, W. S., Alison, J. A., Hassett, L. M., Nisbet, G., Refshauge, K. M., Sherrington, C., & Williams, A. (2024) · BMC Family Practice · doi:10.1186/s12875-024-02570-7 · Cited by 9

Authors: Choi, B. K., Verbeek, J. H., Tam, W. W.-S., & Jiang, J. Y.
Affiliations: Ministry of Health (SG)
Finnish Institute of Occupational Health (FI)
University of Hong Kong (HK)
Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
ORCID: Verbeek, Jos H
Tam, Wilson Wai-San
Venue: Cochrane Database of Systematic Reviews
Publisher: Wiley
Published: 2010-01-20
Volume: 2011
Issue: 2
Pages: CD006555-CD006555
ISSN: 1361-6137 (ISSN-L)
1465-1858
DOI: 10.1002/14651858.cd006555.pub2
PMC: PMC8078403
OpenAlex: W3023541904
Cited by: 207
References: 64
Citations by year: 2026: 3 · 2025: 7 · 2024: 12 · 2023: 15 · 2022: 18 · 2021: 16 · 2020: 11 · 2019: 11 · 2018: 18 · 2017: 19 · 2016: 16 · 2015: 8 · 2014: 9 · 2013: 13 · 2012: 9
FWCI: 1.55
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Cochrane Database of Systematic Reviews (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy-related medical research
Keywords: low back pain, exercise therapy, back pain prevention, sick leave, disability
MeSH terms: Exercise Therapy, Humans, Randomized Controlled Trials as Topic, Low Back Pain, Secondary Prevention

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Exercises for prevention of recurrences of low-back pain

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