scholarly journals Effect of Home Exercise Training in Patients with Nonspecific Low-Back Pain: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (16) ◽  
pp. 8430
Author(s):  
Chloé Quentin ◽  
Reza Bagheri ◽  
Ukadike C. Ugbolue ◽  
Emmanuel Coudeyre ◽  
Carole Pélissier ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Exercise Training ◽  
Pain Intensity ◽  
Meta Analysis ◽  
Functional Limitation ◽  
Home Exercise ◽  
Low Back ◽  
Home Based ◽  
At Home

Background: Exercise therapy is recommended to treat non-specific low back pain (LBP). Home-based exercises are promising way to mitigate the lack of availability of exercise centers. In this paper, we conducted a systemic review and meta-analysis on the effects of home-based exercise on pain and functional limitation in LBP. Method: PubMed, Cochrane, Embase and ScienceDirect were searched until April 20th, 2021. In order to be selected, studies needed to report the pain and functional limitation of patients before and after home-based exercise or after exercise both in a center and at-home. Random-effect meta-analyses and meta-regressions were conducted. Results: We included 33 studies and 9588 patients. We found that pain intensity decreased in the exclusive home exercise group (Effect size = −0.89. 95% CI −0.99 to −0.80) and in the group which conducted exercise both at-home and at another setting (−0.73. −0.86 to −0.59). Similarly, functional limitation also decreased in both groups (−0.75. −0.91 to −0.60, and −0.70, −0.92 to −0.48, respectively). Relaxation and postural exercise seemed to be ineffective in decreasing pain intensity, whereas trunk, pelvic or leg stretching decreased pain intensity. Yoga improved functional limitation. Supervised training was the most effective method to improve pain intensity. Insufficient data precluded robust conclusions around the duration and frequency of the sessions and program. Conclusion: Home-based exercise training improved pain intensity and functional limitation parameters in LBP.

scholarly journals Expression of concern: Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis

2020 ◽  
pp. bjsports-2019-100886eoc1
Keyword(s):  
British Journal ◽  
Low Back Pain ◽  
Back Pain ◽  
Clinical Practice ◽  
Exercise Training ◽  
Sports Medicine ◽  
Meta Analysis ◽  
Editorial Note ◽  
Low Back ◽  
Recent Editorial

Editorial NoteAs discussed in a recent editorial, the British Journal of Sports Medicine (BJSM) rescinds the Expression of Concern [1] for a recent network meta-analysis (NMA) [2] that was issued solely on the basis of comments by Professor Maher and colleagues [3]. The original authors (Dr Belavy and colleagues) have responded [4]. The original NMA paper did not require any changes. We editors of the BJSM have full confidence in the findings of the NMA [2]. The findings of the NMA inform clinical practice and can serve to inform clinical practice guidelines.Karim Khan, MD, PhDEditor-in-Chief, BJSMJuly 27th, 2020REFERENCES1 Expression of concern: Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med 2020;:bjsports-2019-100886eoc1. doi:10.1136/bjsports-2019-100886eoc12 Owen PJ, Miller CT, Mundell NL, et al. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med 2019;:in press. doi:10.1136/bjsports-2019-1008863 Maher CG, Hayden JA, Saragiotto BT, et al. Letter in response to: “Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis” by Owen et al. Br J Sports Med Published Online First: 5 February 2020. doi:10.1136/bjsports-2019-1018124 Belavy DL, Owen PJ, Miller CT, et al. Response to Discussion: “Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis.” Br J Sports Med Published Online First: 10 June 2020. doi:10.1136/bjsports-2020-102673

scholarly journals Effects of Whole-Body Electromyostimulation on Low Back Pain in People with Chronic Unspecific Dorsal Pain: A Meta-Analysis of Individual Patient Data from Randomized Controlled WB-EMS Trials

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Wolfgang Kemmler ◽  
Anja Weissenfels ◽  
Michael Bebenek ◽  
Michael Fröhlich ◽  
Heinz Kleinöder ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Whole Body ◽  
Group Differences ◽  
Low Back ◽  
Randomized Controlled

In order to evaluate the favorable effect of whole-body electromyostimulation (WB-EMS) on low back pain (LBP), an aspect which is frequently claimed by commercial providers, we performed a meta-analysis of individual patient data. The analysis is based on five of our recently conducted randomized controlled WB-EMS trials with adults 60 years+, all of which applied similar WB-EMS protocols (1.5 sessions/week, bipolar current, 16–25 min/session, 85 Hz, 350 μs, and 4–6 s impulse/4 s impulse-break) and used the same pain questionnaire. From these underlying trials, we included only subjects with frequent-chronic LBP in the present meta-analysis. Study endpoints were pain intensity and frequency at the lumbar spine. In summary, 23 participants of the underlying WB-EMS and 22 subjects of the control groups (CG) were pooled in a joint WB-EMS and CG. At baseline, no group differences with respect to LBP intensity and frequency were observed. Pain intensity improved significantly in the WB-EMS (p<.001) and was maintained (p=.997) in the CG. LBP frequency decreased significantly in the WB-EMS (p<.001) and improved nonsignificantly in the CG (p=.057). Group differences for both LBP parameters were significant (p≤.035). We concluded that WB-EMS appears to be an effective training tool for reducing LBP; however, RCTs should further address this issue with more specified study protocols.

Efficacy of risk factor education on pain intensity and disability in office workers with nonspecific neck or low back pain: A pilot cluster randomized clinical trial

2020 ◽  
pp. 1-9
Author(s):  
Rattaporn Sihawong ◽  
Pooriput Waongenngarm ◽  
Prawit Janwantanakul
Keyword(s):  
Risk Factor ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Exercise Program ◽  
Office Workers ◽  
Low Back ◽  
Home Based ◽  
Cluster Randomized ◽  
Disability Level

BACKGROUND: Musculoskeletal disorders are of multi-factorial origin, including individual, physical, and psychosocial factors. An effective education program for musculoskeletal disorders should include predisposing factors. OBJECTIVE: This study aimed to examine the effect of risk factor education on pain intensity and disability levels compared to a home-based exercise program in office workers with nonspecific neck or low back pain. METHODS: A pilot cluster randomized clinical trial was conducted in 46 workers with neck or low back pain. The education group received checklists of risk factors and handbooks providing information on how to manage them. The exercise group received a home-based exercise program to manage their neck or low back pain. The primary outcome measures were pain intensity and disability levels. RESULTS: There was no significant difference in pain intensity or disability level between groups at baseline and follow-ups. However, neck and low back pain intensity, but not disability level, at the 3-month and 6-month follow-ups was significantly lower than those at baseline in both groups. CONCLUSION: Risk factor education was not more effective than the home-based exercise program in terms of pain intensity or disability reduction in workers with nonspecific neck or low back pain.

scholarly journals The Beneficial Effects of Traditional Chinese Exercises for Adults with Low Back Pain: A Meta-Analysis of Randomized Controlled Trials

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 118 ◽  
Author(s):  
Yanjie Zhang ◽  
Paul D. Loprinzi ◽  
Lin Yang ◽  
Jing Liu ◽  
Shijie Liu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Randomized Controlled Trials ◽  
Pain Intensity ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Low Back ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Vas Scores

Objective: The aim of this meta-analytic review was to quantitatively examine the effects of traditional Chinese exercises (TCE) on pain intensity and back disability in individuals with low back pain (LBP). Methods: Potential articles were retrieved using seven electronic databases (Medline, Embase, Cinahl, Web of Science, Cochrane library, China National Knowledge Infrastructure, and Wanfang). The searched period was from inception to 1 March 2019. Randomized controlled trials (RCTs) assessing the effect of TCE on pain intensity and back disability in LBP patients were included. Pooled effect sizes were calculated using the random-effects models and 95% confidence interval (95% CI). Results: Data from eleven RCTs (886 individuals with LBP) meeting the inclusion criteria were extracted for meta-analysis. Compared with the control intervention, TCE induced significant improvements in the visual analogue scale (VAS) (Hedge’s g = −0.64, 95% CI −0.90 to −0.37, p < 0.001), Roland–Morris Disability Questionnaire (RMDQ) (Hedge’s g = −0.41, 95% CI −0.79 to −0.03, p = 0.03), Oswestry Disability Index (ODI) (Hedge’s g = −0.96, 95% CI −1.42 to −0.50, p < 0.001), and cognitive function (Hedge’s g = −0.62, 95% CI −0.85 to −0.39, p < 0.001). In a meta-regression analysis, age (β = 0.01, p = 0.02) and total exercise time (β = −0.0002, p = 0.01) were associated with changes in the VAS scores, respectively. Moderator analyses demonstrated that Tai Chi practice (Hedge’s g = −0.87, 95% CI −1.38 to −0.36, p < 0.001) and Qigong (Hedge’s g = −0.54, 95% CI −0.86 to −0.23, p < 0.001) reduced VAS scores. Interventions with a frequency of 1–2 times/week (Hedge’s g = −0.53, 95% CI −0.98 to −0.07, p = 0.02) and 3–4 times/week (Hedge’s g = −0.78, 95% CI −1.15 to −0.42, p < 0.001) were associated with reduced VAS scores, but this significant reduction on this outcome was not observed in the weekly training frequency of ≥5 times (Hedge’s g = −0.54, 95% CI −1.16 to 0.08, p = 0.09). Conclusions: TCE may have beneficial effects for reducing pain intensity for individuals with LBP, regardless of their pain status.

scholarly journals Virtual Reality in the Treatment of Adults with Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

2021 ◽  
Vol 18 (22) ◽  
pp. 11806
Author(s):  
Beatriz Brea-Gómez ◽  
Irene Torres-Sánchez ◽  
Araceli Ortiz-Rubio ◽  
Andrés Calvache-Mateo ◽  
Irene Cabrera-Martos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Chronic Low Back Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Low Back

Virtual reality (VR) can present advantages in the treatment of chronic low back pain. The objective of this systematic review and meta-analysis was to analyze the effectiveness of VR in chronic low back pain. This review was designed according to PRISMA and registered in PROSPERO (CRD42020222129). Four databases (PubMed, Cinahl, Scopus, Web of Science) were searched up to August 2021. Inclusion criteria were defined following PICOS recommendations. Methodological quality was assessed with the Downs and Black scale and the risk of bias with the Cochrane Risk of Bias Assessment Tool. Fourteen studies were included in the systematic review and eleven in the meta-analysis. Significant differences were found in favor of VR compared to no VR in pain intensity postintervention (11 trials; n = 569; SMD = −1.92; 95% CI = −2.73, −1.11; p < 0.00001) and followup (4 trials; n = 240; SDM = −6.34; 95% CI = −9.12, −3.56; p < 0.00001); and kinesiophobia postintervention (3 trials; n = 192; MD = −8.96; 95% CI = −17.52, −0.40; p = 0.04) and followup (2 trials; n = 149; MD = −12.04; 95% CI = −20.58, −3.49; p = 0.006). No significant differences were found in disability. In conclusion, VR can significantly reduce pain intensity and kinesiophobia in patients with chronic low back pain after the intervention and at followup. However, high heterogeneity exists and can influence the consistency of the results.

Response to Discussion: ‘Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis’

2020 ◽  
pp. bjsports-2020-102673 ◽  
Author(s):  
Daniel L Belavy ◽  
Patrick J Owen ◽  
Clint T Miller ◽  
Niamh L Mundell ◽  
Scott D Tagliaferri ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Exercise Training ◽  
Meta Analysis ◽  
Low Back

Short-Term Effect of Kinesiotaping on Chronic Nonspecific Low Back Pain and Disability: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 100 (2) ◽  
pp. 238-254
Author(s):  
Shanshan Lin ◽  
Bo Zhu ◽  
Guozhi Huang ◽  
Chuhuai Wang ◽  
Qing Zeng ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Randomized Controlled Trials ◽  
Pain Intensity ◽  
Data Extraction ◽  
Meta Analysis ◽  
Pain Reduction ◽  
Controlled Trials ◽  
Low Back ◽  
Randomized Controlled

Abstract Background Low back pain (LBP) is a very common and disabling disorder in modern society. The intervention strategies for LBP include drug therapy, surgery, and physical interventions. Recently, kinesiotaping, as a simple and noninvasive treatment, has been used to treat chronic nonspecific LBP, but its effectiveness and true merit remains unclear. Purpose The purpose of this study was to summarize the results of randomized controlled trials (RCTs) on the effectiveness of kinesiotaping (KT) for chronic nonspecific low back pain (CNLBP) and disability. Data Sources Medline, Cochrane Library, Google Scholar, Web of Science, and EmBase were searched from inception to September 1, 2018. Study Selection Studies were included in the review if they met the following criteria: RCTs published in English; patients (&gt;18 years old) diagnosed with CNLBP (pain duration of &gt; 12 weeks), with or without leg pain; KT as a single treatment or as a part of other forms of physical therapy; outcomes measured included pain intensity and disability. Data Extraction Three independent investigators completed data extraction. Methodological quality was appraised using the Cochrane tool for assessing the risk of bias. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) guidelines were applied to assess the confidence of the effect estimates. Data Synthesis Eleven RCT studies involving 785 patients were retained for the meta-analysis. Standardized mean differences (SMDs) with 95% CIs were calculated using a random-effects model. Compared with the control group， the pooled SMD of pain intensity was significantly reduced (SMD = −0.73; 95% CI = −1.12 to −0.35; GRADE: low) and disability was improved (SMD = −0.51; 95% CI = −0.85 to −0.17; GRADE: low) in the KT group. Subgroup analyses showed that, compared with the control, the I strip of KT significantly reduced pain (SMD = −0.48; GRADE: low) but not disability (SMD = −0.26; GRADE: low). Compared with sham/placebo tape, KT provided significant pain reduction (SMD = −0.84; GRADE: low) and disability improvement (SMD = −0.56; GRADE: low). Moreover, compared with the no-tape group, the KT group also showed pain reduction (SMD = −0.74; GRADE: low) and disability improvement (SMD = −0.65; GRADE: low). Limitations Limitations of the review included a lack of homogeneity, different methodologies and treatment duration of KT application, and relatively small sample sizes. Conclusions There is low-quality evidence that KT has a beneficial role in pain reduction and disability improvement for patients with CNLBP. More high-quality studies are required to confirm the effects of KT on CNLBP.

scholarly journals Efficacy, acceptability, and safety of antidepressants for low back pain: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Michael C. Ferraro ◽  
Matthew K. Bagg ◽  
Michael A. Wewege ◽  
Aidan G. Cashin ◽  
Hayley B. Leake ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Meta Analysis ◽  
Low Back ◽  
Trial Registry ◽  
Clinical Trial Registry ◽  
Link Type ◽  
Stopping Treatment

Abstract Background Antidepressant medicines are used to manage symptoms of low back pain. The efficacy, acceptability, and safety of antidepressant medicines for low back pain (LBP) are not clear. We aimed to evaluate the efficacy, acceptability, and safety of antidepressant medicines for LBP. Methods We searched CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, the EU Clinical Trials Register, and the WHO International Clinical Trial Registry Platform from inception to May 2020. We included published and trial registry reports of RCTs that allocated adult participants with LBP to receive an antidepressant medicine or a placebo medicine. Pairs of authors independently extracted data in duplicate. We extracted participant characteristics, study sample size, outcome values, and measures of variance for each outcome. We data using random-effects meta-analysis models and calculated estimates of effects and heterogeneity for each outcome. We formed judgments of confidence in the evidence in accordance with GRADE. We report our findings in accordance with the PRISMA statement. We prespecified all outcomes in a prospectively registered protocol. The primary outcomes were pain intensity and acceptability. We measured pain intensity at end-of-treatment on a 0–100 point scale and considered 10 points the minimal clinically important difference. We defined acceptability as the odds of stopping treatment for any reason. Results We included 23 RCTs in this review. Data were available for pain in 17 trials and acceptability in 14 trials. Treatment with antidepressants decreased pain intensity by 4.33  points (95% CI − 6.15 to − 2.50) on a 0–100 scale, compared to placebo. Treatment with antidepressants increased the odds of stopping treatment for any reason (OR 1.27 [95% CI 1.03 to 1.56]), compared to placebo. Conclusions Treatment of LBP with antidepressants is associated with small reductions in pain intensity and increased odds of stopping treatment for any reason, compared to placebo. The effect on pain is not clinically important. The effect on acceptability warrants consideration. These findings provide Level I evidence to guide clinicians in their use of antidepressants to treat LBP. Trial registration We prospectively registered the protocol for this systematic review on PROSPERO (CRD42020149275).

scholarly journals Motor Control Stabilisation Exercise for Patients with Non-Specific Low Back Pain: A Prospective Meta-Analysis with Multilevel Meta-Regressions on Intervention Effects

2020 ◽  
Vol 9 (9) ◽  
pp. 3058
Author(s):  
Daniel Niederer ◽  
Tilman Engel ◽  
Lutz Vogt ◽  
Adamantios Arampatzis ◽  
Winfried Banzer ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Pain Intensity ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Control Group ◽  
Low Back ◽  
Meta Analyses ◽  
Quality Evidence

Low-to-moderate quality meta-analytic evidence shows that motor control stabilisation exercise (MCE) is an effective treatment of non-specific low back pain. A possible approach to overcome the weaknesses of traditional meta-analyses would be that of a prospective meta-analyses. The aim of the present analysis was to generate high-quality evidence to support the view that motor control stabilisation exercises (MCE) lead to a reduction in pain intensity and disability in non-specific low back pain patients when compared to a control group. In this prospective meta-analysis and sensitivity multilevel meta-regression within the MiSpEx-Network, 18 randomized controlled study arms were included. Participants with non-specific low back pain were allocated to an intervention (individualized MCE, 12 weeks) or a control group (no additive exercise intervention). From each study site/arm, outcomes at baseline, 3 weeks, 12 weeks, and 6 months were pooled. The outcomes were current pain (NRS or VAS, 11 points scale), characteristic pain intensity, and subjective disability. A random effects meta-analysis model for continuous outcomes to display standardized mean differences between intervention and control was performed, followed by sensitivity multilevel meta-regressions. Overall, 2391 patients were randomized; 1976 (3 weeks, short-term), 1740 (12 weeks, intermediate), and 1560 (6 months, sustainability) participants were included in the meta-analyses. In the short-term, intermediate and sustainability, moderate-to-high quality evidence indicated that MCE has a larger effect on current pain (SMD = −0.15, −0.15, −0.19), pain intensity (SMD = −0.19, −0.26, −0.26) and disability (SMD = −0.15, −0.27, −0.25) compared with no exercise intervention. Low-quality evidence suggested that those patients with comparably intermediate current pain and older patients may profit the most from MCE. Motor control stabilisation exercise is an effective treatment for non-specific low back pain. Sub-clinical intermediate pain and middle-aged patients may profit the most from this intervention.

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