scholarly journals Exercise interventions can improve muscle strength, endurance, and electrical activity of lumbar extensors in individuals with non-specific low back pain: a systematic review with meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sacha Clael ◽  
Lorrane Freitas Campos ◽  
Karina Lisboa Correia ◽  
Joana Marcela Sales de Lucena ◽  
Paulo Gentil ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Muscle Strength ◽  
Electrical Activity ◽  
Meta Analysis ◽  
Low Back ◽  
Exercise Interventions ◽  
Evidence Database ◽  
Active Controls ◽  
Improve Muscle Strength

AbstractExercise interventions have been recommended for people with non-specific low back pain. The literature is scarce regarding the effects of exercise on muscle strength, endurance, and electrical activity of lumbar extensor muscles. Electronic searches were carried out from May 2020 until August 2020 in the following databases: PUBMED, CENTRAL, EMBASE, PEDro, SPORTDiscus, Scielo, and LILACS. Only randomized controlled trials with passive and active control groups were included. The methodological quality of the included studies was performed using the Physiotherapy Evidence Database Scale. Eight studies, involving 508 participants, were included in metanalytical procedures. Exercise interventions demonstrated superior effects on muscle activity (Electromyography) when compared with active controls (p < 0.0001). Exercise interventions demonstrated superior effects on muscle endurance (Sorensen Test) when compared with passive (p = 0.0340) and active controls (p = 0.0276). Exercise interventions demonstrated superior effects on muscle strength (Machine) when compared with passive controls (p = 0.0092). Exercise interventions can improve muscle strength, endurance, and electrical activity in people with non-specific low back pain.

scholarly journals Posterior-Chain Resistance Training Compared to General Exercise and Walking Programmes for the Treatment of Chronic Low Back Pain in the General Population: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nicholas Tataryn ◽  
Vini Simas ◽  
Tailah Catterall ◽  
James Furness ◽  
Justin W. L. Keogh
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Resistance Training ◽  
Muscle Strength ◽  
Adverse Events ◽  
Muscular Strength ◽  
Meta Analysis ◽  
Low Back ◽  
Pain Level ◽  
General Exercise

Abstract Background While chronic exercise training has been demonstrated to be an effective non-pharmacological treatment for chronic low back pain (CLBP), there has been a relative lack of evidence or clinical guidelines for whether a posterior chain resistance training programme provides any benefits over general exercise (GE). Objectives To determine if chronic posterior chain resistance training (PCRT), defined as exercise programmes of ≥6 weeks duration focused on the thoracic, lumbar and hip extensor musculature, is more effective than GE in improving pain, level of disability, muscular strength and the number of adverse events in recreationally active and sedentary individuals with CLBP. Methods Four electronic databases were systematically searched from 25 September 2019 until 30 August 2020. Using the Joanna Briggs Institute (JBI) Critical Appraisal Tools checklist for randomized controlled trials (RCTs), articles were critically appraised and compared against the inclusion/exclusion criteria. Standardized mean difference (SMD), risk difference (RD) and confidence interval (CI) were calculated using Review Manager 5.3. Results Eight articles were included, with a total of 408 participants (203 PCRT, 205 GE). Both PCRT and GE were effective in improving a number of CLBP-related outcomes, but these effects were often significantly greater in PCRT than GE, especially with greater training durations (i.e. 12–16 weeks compared to 6–8 weeks). Specifically, when compared to GE, PCRT demonstrated a greater reduction in pain (SMD = − 0.61 (95% CI − 1.21 to 0.00), p = 0.05; I2 = 74%) and level of disability (SMD = − 0.53 (95% CI − 0.97 to − 0.09), p = 0.02; I2 = 52%), as well as a greater increase in muscle strength (SMD = 0.67 (95% CI 0.21 to 1.13), p = 0.004; I2 = 0%). No differences in the number of adverse events were reported between PCRT and GE (RD = − 0.02 (95% CI − 0.10 to 0.05), p = 0.57; I2 = 72%). Conclusion Results of the meta-analysis indicated that 12–16 weeks of PCRT had a statistically significantly greater effect than GE on pain, level of disability and muscular strength, with no significant difference in the number of adverse events for recreationally active and sedentary patients with CLBP. Clinicians should strongly consider utilizing PCRT interventions for 12–16 weeks with patients with CLBP to maximize their improvements in pain, disability and muscle strength. Future research should focus on comparing the efficacy and adverse events associated with specific PCRT exercise training and movement patterns (i.e. deadlift, hip lift) in treating this population. Trial registration PROSPERO CRD42020155700.

scholarly journals Best Evidence Rehabilitation for Chronic Pain Part 3: Low Back Pain

2019 ◽  
Vol 8 (7) ◽  
pp. 1063 ◽  
Author(s):  
Anneleen Malfliet ◽  
Kelly Ickmans ◽  
Eva Huysmans ◽  
Iris Coppieters ◽  
Ward Willaert ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Treatment Guidelines ◽  
Meta Analysis ◽  
Spinal Manipulative Therapy ◽  
Treatment Decision ◽  
Low Back ◽  
Exercise Interventions ◽  
Treatment Decision Making ◽  
Conflicting Evidence

Chronic Low Back Pain (CLBP) is a major and highly prevalent health problem. Given the high number of papers available, clinicians might be overwhelmed by the evidence on CLBP management. Taking into account the scale and costs of CLBP, it is imperative that healthcare professionals have access to up-to-date, evidence-based information to assist them in treatment decision-making. Therefore, this paper provides a state-of-the-art overview of the best evidence non-invasive rehabilitation for CLBP. Taking together up-to-date evidence from systematic reviews, meta-analysis and available treatment guidelines, most physically inactive therapies should not be considered for CLBP management, except for pain neuroscience education and spinal manipulative therapy if combined with exercise therapy, with or without psychological therapy. Regarding active therapy, back schools, sensory discrimination training, proprioceptive exercises, and sling exercises should not be considered due to low-quality and/or conflicting evidence. Exercise interventions on the other hand are recommended, but while all exercise modalities appear effective compared to minimal/passive/conservative/no intervention, there is no evidence that some specific types of exercises are superior to others. Therefore, we recommend choosing exercises in line with the patient’s preferences and abilities. When exercise interventions are combined with a psychological component, effects are better and maintain longer over time.

scholarly journals Comparative efficacy of different exercise interventions in chronic non-specific low back pain: protocol of a systematic review and network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e036050
Author(s):  
Dennis Anheyer ◽  
Petra Klose ◽  
Anna Katharina Koch ◽  
Heidemarie Haller ◽  
Gustav Dobos ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Low Back ◽  
Care Providers ◽  
Comparative Efficacy ◽  
Exercise Interventions

IntroductionChronic non-specific low back pain is a major public health problem. Evidence supports the effectiveness of exercise as an intervention. Due to a paucity of direct comparisons of different exercise categories, medical guidelines were unable to make specific recommendations regarding the type of exercise working best in improving chronic low back pain. This network meta-analysis (NMA) of randomised controlled trials aims to investigate the comparative efficacy of different exercise interventions in patients with chronic non-specific low back pain.Methods and analysisMEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, SPORTDiscus, Clinicaltrials.gov and the WHO International Clinical Trials Registry Platform search portal were searched on November 2019 and without language restrictions. The search will be updated after data analysis. Studies on adults with non-specific low back pain of at least 12 weeks duration comparing exercise to either no specific intervention (ie, no treatment, wait-list or usual care at the treating physician’s discretion) and/or functionally inert interventions (ie, sham or attention control interventions) will be eligible. Pain intensity and back-specific disability are defined as primary outcomes. Secondary outcomes will include health-related physical and mental quality of life, work disability, frequency of analgesic use and adverse events. All outcomes will be analysed short-term, intermediate-term and long-term. Data will be extracted independently by two review authors. Risk of bias will be assessed using the recommendations by the Cochrane Back and Neck Group and be based on an adaptation of the Cochrane Risk of Bias tool.Ethics and disseminationThis NMA will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses_NMA checklist. The results will be presented in peer-reviewed journals, implemented in existing national and international guidelines and will be presented to health care providers and decision makers. The planned completion date of the study is 1 July 2021.PROSPERO registration numberCRD42020151472.

scholarly journals Relative effectiveness of different forms of exercises for treatment of chronic low back pain: protocol for a systematic review incorporating Bayesian network meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e025971
Author(s):  
Chengfei Gao ◽  
Guanghui Chen ◽  
Hui Yang ◽  
Zhen Hua ◽  
Peng Xu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Relative Effectiveness ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Low Back ◽  
Exercise Interventions

IntroductionExercise is considered as an effective intervention in the management of patients with chronic low back pain (cLBP). However, the relative effectiveness as well as the hierarchy of exercise interventions have not been well established, although various exercise options are available. Therefore, the present protocol proposes to conduct a network meta-analysis (NMA) aiming to evaluate the effectiveness of different forms of exercise for treatment of cLBP.Methods and analysisMedline, Embase, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Central Register of Controlled Trials, and the Physiotherapy Evidence Database will be searched to identify all randomised controlled trials that evaluate the effectiveness of exercise in the treatment of cLBP. There will be no restrictions on date or language. Two authors will screen the literature and extract data independently based on predesigned rules, and evaluate the risk of bias of included studies using the Cochrane Risk of Bias Tool. Disagreements will be resolved through discussion or consultation with a senior reviewer. The primary outcomes of this study will be pain relief and improvement in function or disability for all interventions. Traditional pairwise meta-analysis and Bayesian NMA will be conducted to compare the effectiveness of different exercise interventions. The ranking probabilities for all interventions will be estimated and the hierarchy of each intervention will be summarised as surface under the cumulative ranking curve. The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation instrument.Ethics and disseminationEthical approval and informed consent are not required since this is a protocol for a meta-analysis with no confidential personal data to be collected. The results of this NMA will be submitted to a peer-reviewed journal for publication.PROSPERO registration numberCRD42018090576.

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