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Exercise and chronic low back pain: what works?
Pain. 2004 Jan; 107(1-2):176-90.PAIN

Abstract

The aim of this review was to investigate current evidence for the type and quality of exercise being offered to chronic low back pain (CLBP) patients, within randomised controlled trials (RCTs), and to assess how treatment outcomes are being measured. A two-fold methodological approach was adopted: a methodological assessment identified RCTs of 'medium' or 'high' methodological quality. Exercise quality was subsequently assessed according to the predominant exercise used. Outcome measures were analysed based on current recommendations. Fifty-four relevant RCTs were identified, of which 51 were scored for methodological quality. Sixteen RCTs involving 1730 patients qualified for inclusion in this review based upon their methodological quality, and chronicity of symptoms; exercise had a positive effect in all 16 trials. Twelve out of 16 programmes incorporated strengthening exercise, of which 10 maintained their positive results at follow-up. Supervision and adequate compliance were common aspects of trials. A wide variety of outcome measures were used. Outcome measures did not adequately represent the guidelines for impairment, activity and participation, and impairment measures were over-represented at the expense of others. Despite the variety offered, exercise has a positive effect on CLBP patients, and results are largely maintained at follow-up. Strengthening is a common component of exercise programmes, however, the role of exercise co-interventions must not be overlooked. More high quality trials are needed to accurately assess the role of supervision and follow-up, together with the use of more appropriate outcome measures.

Authors+Show Affiliations

Rehabilitation Sciences Research Group, University of Ulster at Jordanstown, Shore Road, Newtownabbey, Co. Antrim BT37 OQB, Northern Ireland, UK. sd.liddle@ulster.ac.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

14715404

Citation

Liddle, Sarah Dianne, et al. "Exercise and Chronic Low Back Pain: what Works?" Pain, vol. 107, no. 1-2, 2004, pp. 176-90.
Liddle SD, Baxter GD, Gracey JH. Exercise and chronic low back pain: what works? Pain. 2004;107(1-2):176-90.
Liddle, S. D., Baxter, G. D., & Gracey, J. H. (2004). Exercise and chronic low back pain: what works? Pain, 107(1-2), 176-90.
Liddle SD, Baxter GD, Gracey JH. Exercise and Chronic Low Back Pain: what Works. Pain. 2004;107(1-2):176-90. PubMed PMID: 14715404.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exercise and chronic low back pain: what works? AU - Liddle,Sarah Dianne, AU - Baxter,G David, AU - Gracey,Jacqueline H, PY - 2004/1/13/pubmed PY - 2004/3/23/medline PY - 2004/1/13/entrez SP - 176 EP - 90 JF - Pain JO - Pain VL - 107 IS - 1-2 N2 - The aim of this review was to investigate current evidence for the type and quality of exercise being offered to chronic low back pain (CLBP) patients, within randomised controlled trials (RCTs), and to assess how treatment outcomes are being measured. A two-fold methodological approach was adopted: a methodological assessment identified RCTs of 'medium' or 'high' methodological quality. Exercise quality was subsequently assessed according to the predominant exercise used. Outcome measures were analysed based on current recommendations. Fifty-four relevant RCTs were identified, of which 51 were scored for methodological quality. Sixteen RCTs involving 1730 patients qualified for inclusion in this review based upon their methodological quality, and chronicity of symptoms; exercise had a positive effect in all 16 trials. Twelve out of 16 programmes incorporated strengthening exercise, of which 10 maintained their positive results at follow-up. Supervision and adequate compliance were common aspects of trials. A wide variety of outcome measures were used. Outcome measures did not adequately represent the guidelines for impairment, activity and participation, and impairment measures were over-represented at the expense of others. Despite the variety offered, exercise has a positive effect on CLBP patients, and results are largely maintained at follow-up. Strengthening is a common component of exercise programmes, however, the role of exercise co-interventions must not be overlooked. More high quality trials are needed to accurately assess the role of supervision and follow-up, together with the use of more appropriate outcome measures. SN - 0304-3959 UR - https://www.unboundmedicine.com/medline/citation/14715404/Exercise_and_chronic_low_back_pain:_what_works L2 - https://linkinghub.elsevier.com/retrieve/pii/S0304395903004342 DB - PRIME DP - Unbound Medicine ER -