Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis

Hayden, Jill A; Ellis, Jenna; Ogilvie, Rachel; Stewart, Samuel A; Bagg, Matthew K; Stanojevic, Sanja; Yamato, Tiê P; Saragiotto, Bruno T

doi:10.1016/j.jphys.2021.09.004

Cited by 321Musculoskeletal pain and rehabilitationPregnancy-related medical researchSpine and Intervertebral Disc Pathology

Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis

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Hayden, Jill A, Ellis, Jenna, Ogilvie, Rachel, Stewart, Samuel A, Bagg, Matthew K, Stanojevic, Sanja, Yamato, Tiê P, Saragiotto, Bruno T·2021·Journal of Physiotherapy

DOI 10.1016/j.jphys.2021.09.004

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Abstract

QUESTION: What are the effects of specific types of exercise treatments on pain intensity and functional limitation outcomes for adults with chronic low back pain? DESIGN: Systematic review with network meta-analysis of randomised controlled trials. PARTICIPANTS: Adults with non-specific low back pain for ≥ 12 weeks. INTERVENTION: Exercise treatments prescribed or planned by a health professional that involved conducting specific activities, postures and/or movements with a goal to improve low back pain outcomes. OUTCOME MEASURES: Pain intensity (eg, visual analogue scale or numerical rating scale) and back-related functional limitations (eg, Roland Morris Disability Questionnaire or Oswestry Disability Index), each standardised to range from 0 to 100. RESULTS: This review included 217 randomised controlled trials with 20,969 participants and 507 treatment groups. Most exercise types were more effective than minimal treatment for pain and functional limitation outcomes. Network meta-analysis results were compatible with moderate to clinically important treatment effects for Pilates, McKenzie therapy, and functional restoration (pain only) and flexibility exercises (function only) compared with minimal treatment, other effective treatments and other exercise types. The estimated mean differences for these exercise types compared with minimal treatment ranged from -15 to -19 for pain and from -10 to -12 for functional limitation. CONCLUSION: This review found evidence that Pilates, McKenzie therapy and functional restoration were more effective than other types of exercise treatment for reducing pain intensity and functional limitations. Nevertheless, people with chronic low back pain should be encouraged to perform the exercise that they enjoy to promote adherence. REGISTRATION: DOI:10.1002/14651858.CD009790.

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A recent systematic review with network meta-analysis of 217 randomised controlled trials has shown that patients with low back pain benefit from being encouraged to perform exercises that they enjoy.
“A recent systematic review with an NMA of 217 randomised controlled trials has shown that patients with LBP benefit from being encouraged to perform exercises that they enjoy.118”
From Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis (2022) · cites this paper as [118]

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Authors: Hayden, J. A., Ellis, J., Ogilvie, R., Stewart, S. A., Bagg, M. K., Stanojevic, S., Yamato, T. P., & Saragiotto, B. T.
Affiliations: Dalhousie University (CA)
Department of Water (AU)
The University of Sydney (AU)
Corresponding author: Hayden, Jill A
ORCID: Hayden, Jill A
Ellis, Jenna
Ogilvie, Rachel
Stewart, Samuel A
Bagg, Matthew K
Stanojevic, Sanja
Yamato, Tiê P
Saragiotto, Bruno T
Venue: Journal of Physiotherapy
Publisher: Elsevier BV
Published: 2021-10
Volume: 67
Issue: 4
Pages: 252-262
ISSN: 1836-9553 (ISSN-L)
DOI: 10.1016/j.jphys.2021.09.004
OpenAlex: W3199777986
Cited by: 321
References: 39
Citations by year: 2026: 49 · 2025: 63 · 2024: 72 · 2023: 85 · 2022: 50 · 2021: 2
FWCI: 6.62
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by-nc-nd/4.0/ (vor)
Locations: Journal of physiotherapy (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Fundação de Amparo à Pesquisa do Estado de São Paulo (2019/10330-4, 2020/14231-8)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Keywords: chronic low back pain, exercise therapy, Pilates, McKenzie therapy, functional restoration, flexibility training, pain intensity, functional limitations, disability, exercise adherence, non-specific low back pain
MeSH terms: Network Meta-Analysis, Adult, Exercise Therapy, Humans, Pain Measurement, Low Back Pain, Chronic Pain

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Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis

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