Exercise interventions for the treatment of chronic low back pain

NewsBot · Feb 15, 2015

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Exercise interventions for the treatment of chronic low back pain: A systematic review and meta-analysis of randomised controlled trials.
Searle A, Spink M, Ho A, Chuter V
Clin Rehabil. 2015 Feb 13

OBJECTIVE:
To determine, for adults with chronic low back pain, which exercise interventions are the most effective at reducing pain compared to other treatments.
DATA SOURCES:
A search of MEDLINE, CINAHL, EMBASE, SPORTDiscus, PsycINFO and The Cochrane Library was conducted up to October 2014.
REVIEW METHODS:
Databases were searched for published reports of randomised trials that investigated the treatment of chronic low back pain of non-specific origin with an exercise intervention. Two authors independently reviewed and selected relevant trials. Methodological quality was evaluated using the Downs and Black tool.
RESULTS:
Forty-five trials met the inclusion criteria and thirty-nine were included in the meta-analysis. Combined meta-analysis revealed significantly lower chronic low back pain with intervention groups using exercise compared to a control group or other treatment group (Standard Mean Deviation (SMD) =-0.32, CI 95% -0.44 to -0.19, P<0.01). Separate exploratory subgroup analysis showed a significant effect for strength/resistance and coordination/stabilisation programs.
CONCLUSIONS:
Our results found a beneficial effect for strength/resistance and coordination/stabilisation exercise programs over other interventions in the treatment of chronic low back pain and that cardiorespiratory and combined exercise programs are ineffective.
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Admin2 · Feb 15, 2015

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NewsBot · Dec 29, 2019

Effect of a corrective exercise program on gait kinetics and muscle activities in older adults with both low back pain and pronated feet: A double-blind, randomized controlled trial
MortezaMadadi-ShadaAmir AliJafarnezhadgerobHamedSheikhalizadebValdeci CarlosDionisioc
Gait & Posture 28 December 2019

Highlight
•Walking speed was increased following the corrective exercise program.
•Loading rate and free moment values were not changed following the training.
•Tibialis anterior activity was decreased following the corrective exercise program.
•Muscle activity for rectus abdominis was decreased following the training.
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Background
Low back pain is among the most common health problems seen in primary care. This study aimed to evaluate the effect of a corrective exercise program on GRF components, back pain, disability score, and muscle activities in back pain patients with pronated feet during walking.

Research question
What is the effect of corrective exercise program on gait kinetics, back pain, disability score, and muscle activities in back pain patients with pronated feet during walking?

Methods
Thirty-six older adults with both back pain and pronated feet volunteered to participate in this study. They were randomly divided into two equal groups (experimental and control groups). Kinetic and EMG data were recorded during both pre and posttest. Visual analog pain scale and Roland-Morris disability questionnaire were used to assess back pain and disability values, respectively.

Results
In the experimental group but not in the control group, walking speed was significantly increased from pre to posttest (p = 0.001). The loading rate and free moment values were similar during both the pre and posttest (p > 0.05). In the experimental group but not in the control group, the disability score, back pain, tibialis anterior activity, and rectus abdominis activity were decreased during the posttest than that in the pretest (p < 0.001).

Significance
Higher walking speed, lower muscle activity and pain, lower disability score along with similar loading rate and free moments in the experimental group compared with the control group after the training protocol demonstrate the improvement of gait efficiency.
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NewsBot · Dec 23, 2020

Treating low back pain in athletes: a systematic review with meta-analysis
Jane S Thornton et al
British Journal of Sports Medicine Published Online First: 21 December 2020

Objective To summarise the evidence for non-pharmacological management of low back pain (LBP) in athletes, a common problem in sport that can negatively impact performance and contribute to early retirement.

Data sources Five databases (EMBASE, Medline, CINAHL, Web of Science, Scopus) were searched from inception to September 2020. The main outcomes of interest were pain, disability and return to sport (RTS).

Results Among 1629 references, 14 randomised controlled trials (RCTs) involving 541 athletes were included. The trials had biases across multiple domains including performance, attrition and reporting. Treatments included exercise, biomechanical modifications and manual therapy. There were no trials evaluating the efficacy of surgery or injections. Exercise was the most frequently investigated treatment; no RTS data were reported for any exercise intervention. There was a reduction in pain and disability reported after all treatments.

Conclusions While several treatments for LBP in athletes improved pain and function, it was unclear what the most effective treatments were, and for whom. Exercise approaches generally reduced pain and improved function in athletes with LBP, but the effect on RTS is unknown. No conclusions regarding the value of manual therapy (massage, spinal manipulation) or biomechanical modifications alone could be drawn because of insufficient evidence. High-quality RCTs are urgently needed to determine the effect of commonly used interventions in treating LBP in athletes.
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