Exercise therapy for treatment of non-specific low back pain

Hayden, Jill A.; Tulder, Maurits W. van; Malmivaara, Antti; Koes, Bart W.

doi:10.1002/14651858.cd000335.pub2

Cited by 646 publications

(577 citation statements)

References 117 publications

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“…In recent reviews on exercise therapy the specific value of aerobic exercises could not be evaluated since only a minority of the studies had specifically used aerobic exercises [1,14].…”

Section: Discussionmentioning

confidence: 99%

“…It is also doubtful whether persons with back pain develop aerobic deconditioning or whether reduced aerobic fitness is associated with other aspects related to CBP such as pain intensity, activity limitation, depression, fear of injury and kinesiophobia [7,15,26,37,38,42,43]. Furthermore, there is inconclusive evidence for the predictive value of aerobic fitness for work-return in CBP [20,22,24,33] Although in general aerobic fitness shows a doseresponse relation to health outcomes [3], at present, there is modest evidence to suggest that exercise therapy and behavioural and multidisciplinary treatment programs that include exercise therapy are effective in reducing pain, improving physical functioning and activity and reducing the number of sick days in CBP [6,19,23,27,34]. Depending on intensity and duration, many of these programs for persons with CBP that include aerobic training do indeed affect aerobic fitness [28,33,36].…”

Section: Introductionmentioning

confidence: 99%

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The impact of aerobic fitness on functioning in chronic back pain

Wormgoor¹,

Indahl²,

Tulder

et al. 2007

Eur Spine J

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Despite lack of convincing evidence that reduced aerobic fitness is associated with chronic back pain (CBP), exercise programs are regarded as being effective for persons with non-specific CBP. It is unsure whether gain in aerobic fitness following intervention is associated with functioning improvement in persons with CBP. The objective of this prospective cohort study was to study the impact of aerobic fitness on functioning in persons with CBP, at baseline and following 3-week intensive interdisciplinary intervention. This study included persons who had passed 8 weeks of sick-listing because of back pain (n = 94) and were referred to a 3-week intensive biopsychosocial rehabilitation program. Aerobic fitness was assessed with a sub-maximal bicycle test at baseline, at admission to and discharge from the rehabilitation program, and at 6 months follow-up. Contextual factors, body function, activity and participation were evaluated before and after intervention. In addition, working ability was recorded at 3-years followup. At baseline aerobic fitness was reduced in most subjects, but improved significantly following intervention. Baseline measurements and intervention effects did not differ among the diagnostic sub-groups. Neither contextual factors nor functioning at baseline were associated with aerobic fitness. Increase in aerobic fitness was not associated with improvements in functioning and contextual factors and work-return following intervention either. From this study we conclude that improvement of aerobic fitness seems of limited value as goal of treatment outcome for patients with CBP.

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“…In recent reviews on exercise therapy the specific value of aerobic exercises could not be evaluated since only a minority of the studies had specifically used aerobic exercises [1,14].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of aerobic fitness on functioning in chronic back pain

Wormgoor¹,

Indahl²,

Tulder

et al. 2007

Eur Spine J

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“…There is signi icant evidence supporting exercises in the treatment of non-speci ic low back pain (3). These exercises allow patients to acquire lexibility and stability of the lumbar spine, aiming to prevent painful recurrences (4).…”

Section: Introductionmentioning

confidence: 99%

Effect of global postural re-education and isostretching in patients with nonspecific chronic low back pain: a randomized clinical trial

et al. 2016

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Effect of global postural re-education and isostretching in patients with nonspecific chronic low back pain: a randomized clinical trial [I] Efeitos da reeducação postural global e do isostretching em pacientes com lombalgia crônica não-específi ca: ensaio clínico aleatório [A] Fábio Alexandre Moreschi Guastala [a] , Mayara Hilda Guerini [ Abstract Introduction: Low back pain is one of the most prevalent musculoskeletal disorders, but little is known about postural methods in its treatment. Objective: Analyze changes in muscle strength, lexibility, function and pain in patients with chronic low back pain that underwent isostretching and global posture reeducation (GPR). Methods: Thirty-nine patients, aged between 40 and 59 years, were evaluated before and after treatment protocols regarding: lexibility for sit and reach, muscle strength, functional capacity using the Rolland-Morris Questionnaire, and intensity of pain by Visual Analog Scale. The sample was randomized into two groups (1-GPR; 2-Isostretching), all of whom were treated individually through 12 sessions lasting 45 minutes each, twice a week. Results: After treatment, median reduction in pain intensity of 28 mm in group 1 and 32 mm in group 2 was observed, and a median improvement in functional capacity in group 1 of 8.5 points and 7 points in group 2 (p < 0,05). A mean improvement of severn repetitions in trunk extensor muscle strength was observed in group 1 and in group 2; by dynamometry of 10 kg / f in group 1 and 12.5 kg / f in group 2 of ten abdominal repetitions strength in group 1 and four repetitions in group 2 (p < 0.05).In the Sit and Reach, Group 1 had a total mean increase of 3cm, and group 2 had 1.6cm (p < 0.05). Conclusion: Both groups were effective in improvement of muscle strength, lexibility, pain and functional capacity. Keywords

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“…Twenty-one articles 1,6,8,9,[12][13][14][15][20][21][22]24,25,28,33,[38][39][40][42][43][44] were selected for further evaluation. Thirteen reviews 1,6,9,13,15,[20][21][22]38,39,[42][43][44] were eliminated after further evaluation. Reasons for exclusion included assessed outcomes that were not disability or pain in 1 review, 20 interventions that were not focused on specific stabilization exercises in 8 reviews, 9,15,21,38,39,[42][43][44] and the lack of an SR format in 1 review.…”

Section: Resultsmentioning

confidence: 99%

“…Reasons for exclusion included assessed outcomes that were not disability or pain in 1 review, 20 interventions that were not focused on specific stabilization exercises in 8 reviews, 9,15,21,38,39,[42][43][44] and the lack of an SR format in 1 review. 22 Additionally, 2 reviews were practice guidelines, 1,6 and 1 13 was a duplication of findings published in another review. 14 Eight SRs 8,12,14,24,25,28,33,40 fulfilled the inclusion criteria and were included in this review (FIGURE 1).…”

Section: Resultsmentioning

confidence: 99%

Quality of Systematic Reviews on Specific Spinal Stabilization Exercise for Chronic Low Back Pain

Haladay¹,

Miller

Challis

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Systematic literature review. Objective To evaluate the quality of systematic reviews (SRs) on specific stabilization exercises for chronic low back pain (LBP). Background Multiple SRs regarding the effectiveness of lumbar stabilization exercises for people with chronic LBP have been published. As more SRs are published, the more it is recognized that, like other forms of research, methodological quality affects the validity of, and conclusions drawn from, the data. Methods A search of MEDLINE, CINAHL, and Embase was completed. Additionally, the PEDro database was screened and hand searching was completed. Included SRs had to contain randomized controlled trials examining a specific stabilization exercise program for the treatment of chronic LBP. Additionally, the assessed outcome measures had to include pain and/or disability measures. Literature reviews and clinical practice guidelines were excluded. Three reviewers independently assessed each SR for methodological quality. Results The search produced 665 SRs for review, of which 8 fulfilled the inclusion criteria. Consensus quality assessment scores ranged from 13/26 to 26/26, with an average of 20.7 points. Percent agreement and kappa values for individual criteria scores ranged from 50% to 92% and 0.25 to 0.85, respectively. Agreement was moderate to substantial across individual items, except for criterion 1. The intraclass correlation coefficient for overall score was 0.98 (95% confidence interval: 0.96, 0.99). Conclusion This review of SRs identified several high-quality reviews that indicated some benefit of specific stabilization exercise programs for patients with nonspecific chronic LBP. Level of Evidence Therapy, level 1a. J Orthop Sports Phys Ther 2013;43(4):242–250. Epub 14 January 2013. doi:10.2519/jospt.2013.4346

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Exercise therapy for treatment of non-specific low back pain

Cited by 646 publications

References 117 publications

The impact of aerobic fitness on functioning in chronic back pain

The impact of aerobic fitness on functioning in chronic back pain

Effect of global postural re-education and isostretching in patients with nonspecific chronic low back pain: a randomized clinical trial

Quality of Systematic Reviews on Specific Spinal Stabilization Exercise for Chronic Low Back Pain

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