Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured Exercise Programs for Chronic Primary Low Back Pain in Adults
Purpose Evaluate benefits and harms of structured exercise programs for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline. Methods We searched for randomized controlled trials (RCTs) in electronic databases (inception to 17 May 20...
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| Veröffentlicht in: | Journal of occupational rehabilitation 2023-12, Vol.33 (4), p.636-650 |
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| container_title | Journal of occupational rehabilitation |
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| creator | Verville, Leslie Ogilvie, Rachel Hincapié, Cesar A. Southerst, Danielle Yu, Hainan Bussières, André Gross, Douglas P. Pereira, Paulo Mior, Silvano Tricco, Andrea C. Cedraschi, Christine Brunton, Ginny Nordin, Margareta Connell, Gaelan Wong, Jessica J. Shearer, Heather M. Lee, Joyce G. B. Wang, Dan Hayden, Jill A. Cancelliere, Carol |
| description | Purpose
Evaluate benefits and harms of structured exercise programs for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline.
Methods
We searched for randomized controlled trials (RCTs) in electronic databases (inception to 17 May 2022). Eligible RCTs targeted structured exercise programs compared to placebo/sham, usual care, or no intervention (including comparison interventions where the attributable effect of exercise could be isolated). We extracted outcomes, appraised risk of bias, conducted meta-analyses where appropriate, and assessed certainty of evidence using GRADE.
Results
We screened 2503 records (after initial screening through Cochrane RCT Classifier and Cochrane Crowd) and 398 full text RCTs. Thirteen RCTs rated with overall low or unclear risk of bias were synthesized. Assessing individual exercise types (predominantly very low certainty evidence), pain reduction was associated with aerobic exercise and Pilates vs. no intervention, and motor control exercise vs. sham. Improved function was associated with mixed exercise vs. usual care, and Pilates vs. no intervention. Temporary increased minor pain was associated with mixed exercise vs. no intervention, and yoga vs. usual care. Little to no difference was found for other comparisons and outcomes. When pooling exercise types, exercise vs. no intervention probably reduces pain in adults (8 RCTs, SMD = − 0.33, 95% CI − 0.58 to − 0.08) and functional limitations in adults and older adults (8 RCTs, SMD = − 0.31, 95% CI − 0.57 to − 0.05) (moderate certainty evidence).
Conclusions
With moderate certainty, structured exercise programs probably reduce pain and functional limitations in adults and older people with CPLBP. |
| doi_str_mv | 10.1007/s10926-023-10124-4 |
| format | Article |
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Evaluate benefits and harms of structured exercise programs for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline.
Methods
We searched for randomized controlled trials (RCTs) in electronic databases (inception to 17 May 2022). Eligible RCTs targeted structured exercise programs compared to placebo/sham, usual care, or no intervention (including comparison interventions where the attributable effect of exercise could be isolated). We extracted outcomes, appraised risk of bias, conducted meta-analyses where appropriate, and assessed certainty of evidence using GRADE.
Results
We screened 2503 records (after initial screening through Cochrane RCT Classifier and Cochrane Crowd) and 398 full text RCTs. Thirteen RCTs rated with overall low or unclear risk of bias were synthesized. Assessing individual exercise types (predominantly very low certainty evidence), pain reduction was associated with aerobic exercise and Pilates vs. no intervention, and motor control exercise vs. sham. Improved function was associated with mixed exercise vs. usual care, and Pilates vs. no intervention. Temporary increased minor pain was associated with mixed exercise vs. no intervention, and yoga vs. usual care. Little to no difference was found for other comparisons and outcomes. When pooling exercise types, exercise vs. no intervention probably reduces pain in adults (8 RCTs, SMD = − 0.33, 95% CI − 0.58 to − 0.08) and functional limitations in adults and older adults (8 RCTs, SMD = − 0.31, 95% CI − 0.57 to − 0.05) (moderate certainty evidence).
Conclusions
With moderate certainty, structured exercise programs probably reduce pain and functional limitations in adults and older people with CPLBP.</description><identifier>ISSN: 1053-0487</identifier><identifier>EISSN: 1573-3688</identifier><identifier>DOI: 10.1007/s10926-023-10124-4</identifier><identifier>PMID: 37991647</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adults ; Aged ; Back pain ; Bias ; Clinical practice guidelines ; Clinical Psychology ; Clinical trials ; Environmental Health ; Exercise ; Exercise Therapy ; Health Psychology ; Humans ; Intervention ; Low back pain ; Low Back Pain - therapy ; Medicine ; Medicine & Public Health ; Motor task performance ; Occupational Medicine/Industrial Medicine ; Older people ; Orthopedics ; Pain ; Pilates ; Practice Guidelines as Topic ; Randomized Controlled Trials as Topic ; Rehabilitation ; Systematic Review</subject><ispartof>Journal of occupational rehabilitation, 2023-12, Vol.33 (4), p.636-650</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-3b65685584a4cfe1ae81c6db4cd1ef204fcc8ff019cd43d862ab0477a047dfc73</citedby><cites>FETCH-LOGICAL-c475t-3b65685584a4cfe1ae81c6db4cd1ef204fcc8ff019cd43d862ab0477a047dfc73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10926-023-10124-4$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10926-023-10124-4$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,315,782,786,887,27931,27932,41495,42564,51326</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37991647$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Verville, Leslie</creatorcontrib><creatorcontrib>Ogilvie, Rachel</creatorcontrib><creatorcontrib>Hincapié, Cesar A.</creatorcontrib><creatorcontrib>Southerst, Danielle</creatorcontrib><creatorcontrib>Yu, Hainan</creatorcontrib><creatorcontrib>Bussières, André</creatorcontrib><creatorcontrib>Gross, Douglas P.</creatorcontrib><creatorcontrib>Pereira, Paulo</creatorcontrib><creatorcontrib>Mior, Silvano</creatorcontrib><creatorcontrib>Tricco, Andrea C.</creatorcontrib><creatorcontrib>Cedraschi, Christine</creatorcontrib><creatorcontrib>Brunton, Ginny</creatorcontrib><creatorcontrib>Nordin, Margareta</creatorcontrib><creatorcontrib>Connell, Gaelan</creatorcontrib><creatorcontrib>Wong, Jessica J.</creatorcontrib><creatorcontrib>Shearer, Heather M.</creatorcontrib><creatorcontrib>Lee, Joyce G. B.</creatorcontrib><creatorcontrib>Wang, Dan</creatorcontrib><creatorcontrib>Hayden, Jill A.</creatorcontrib><creatorcontrib>Cancelliere, Carol</creatorcontrib><title>Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured Exercise Programs for Chronic Primary Low Back Pain in Adults</title><title>Journal of occupational rehabilitation</title><addtitle>J Occup Rehabil</addtitle><addtitle>J Occup Rehabil</addtitle><description>Purpose
Evaluate benefits and harms of structured exercise programs for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline.
Methods
We searched for randomized controlled trials (RCTs) in electronic databases (inception to 17 May 2022). Eligible RCTs targeted structured exercise programs compared to placebo/sham, usual care, or no intervention (including comparison interventions where the attributable effect of exercise could be isolated). We extracted outcomes, appraised risk of bias, conducted meta-analyses where appropriate, and assessed certainty of evidence using GRADE.
Results
We screened 2503 records (after initial screening through Cochrane RCT Classifier and Cochrane Crowd) and 398 full text RCTs. Thirteen RCTs rated with overall low or unclear risk of bias were synthesized. Assessing individual exercise types (predominantly very low certainty evidence), pain reduction was associated with aerobic exercise and Pilates vs. no intervention, and motor control exercise vs. sham. Improved function was associated with mixed exercise vs. usual care, and Pilates vs. no intervention. Temporary increased minor pain was associated with mixed exercise vs. no intervention, and yoga vs. usual care. Little to no difference was found for other comparisons and outcomes. When pooling exercise types, exercise vs. no intervention probably reduces pain in adults (8 RCTs, SMD = − 0.33, 95% CI − 0.58 to − 0.08) and functional limitations in adults and older adults (8 RCTs, SMD = − 0.31, 95% CI − 0.57 to − 0.05) (moderate certainty evidence).
Conclusions
With moderate certainty, structured exercise programs probably reduce pain and functional limitations in adults and older people with CPLBP.</description><subject>Adults</subject><subject>Aged</subject><subject>Back pain</subject><subject>Bias</subject><subject>Clinical practice guidelines</subject><subject>Clinical Psychology</subject><subject>Clinical trials</subject><subject>Environmental Health</subject><subject>Exercise</subject><subject>Exercise Therapy</subject><subject>Health Psychology</subject><subject>Humans</subject><subject>Intervention</subject><subject>Low back pain</subject><subject>Low Back Pain - therapy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Motor task performance</subject><subject>Occupational Medicine/Industrial Medicine</subject><subject>Older people</subject><subject>Orthopedics</subject><subject>Pain</subject><subject>Pilates</subject><subject>Practice Guidelines as Topic</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Rehabilitation</subject><subject>Systematic Review</subject><issn>1053-0487</issn><issn>1573-3688</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kl1vFCEUhidGY2v1D3hhSLypF6MwwwDjjWk3tdtkk22sppeEZQ671BmowPTrn_nvZJ1aPy5MCJBz3vOcQ3iL4iXBbwnG_F0kuK1Yiau6JJhUtKSPil3S8LqsmRCP8x03dYmp4DvFsxgvMMat4NXTYqfmbUsY5bvF97PbmGBQyWr0Ca4sXKPk0YkzPgxIoXMf-g7NQfVpg5ZhrZy9y1rv0P75fPkGzXrrrFY9Og1KZwag49F2kKPwHh2CA2NTRMplhgpDRN6gsxRGncYAHTq6gaBthFzt10HlfG6LZpvgMzQH7aDCLVr4a3So9Fd0qqxDeR10Y5_i8-KJUX2EF_fnXvHl49Hn2bxcLI9PZgeLUlPepLJesYaJphFUUW2AKBBEs25FdUfAVJgarYUxmLS6o3UnWKVWmHKu8tYZzeu94sPEvRxXA3QaXAqql5fTdNIrK__OOLuRa38lCWaCMtZkwv49IfhvI8QkBxs19L1y4McoK5G_sWlrsW32-h_phR-Dy-_bqmjDW8FYVlWTSgcfYwDzMA3BcmsNOVlDZmvIn9aQNBe9-vMdDyW_vJAF9SSIOeXWEH73_g_2B-nqx40</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Verville, Leslie</creator><creator>Ogilvie, Rachel</creator><creator>Hincapié, Cesar A.</creator><creator>Southerst, Danielle</creator><creator>Yu, Hainan</creator><creator>Bussières, André</creator><creator>Gross, Douglas P.</creator><creator>Pereira, Paulo</creator><creator>Mior, Silvano</creator><creator>Tricco, Andrea C.</creator><creator>Cedraschi, Christine</creator><creator>Brunton, Ginny</creator><creator>Nordin, Margareta</creator><creator>Connell, Gaelan</creator><creator>Wong, Jessica J.</creator><creator>Shearer, Heather M.</creator><creator>Lee, Joyce G. 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B. ; Wang, Dan ; Hayden, Jill A. ; Cancelliere, Carol</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-3b65685584a4cfe1ae81c6db4cd1ef204fcc8ff019cd43d862ab0477a047dfc73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adults</topic><topic>Aged</topic><topic>Back pain</topic><topic>Bias</topic><topic>Clinical practice guidelines</topic><topic>Clinical Psychology</topic><topic>Clinical trials</topic><topic>Environmental Health</topic><topic>Exercise</topic><topic>Exercise Therapy</topic><topic>Health Psychology</topic><topic>Humans</topic><topic>Intervention</topic><topic>Low back pain</topic><topic>Low Back Pain - therapy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Motor task performance</topic><topic>Occupational Medicine/Industrial Medicine</topic><topic>Older people</topic><topic>Orthopedics</topic><topic>Pain</topic><topic>Pilates</topic><topic>Practice Guidelines as Topic</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Rehabilitation</topic><topic>Systematic Review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Verville, Leslie</creatorcontrib><creatorcontrib>Ogilvie, Rachel</creatorcontrib><creatorcontrib>Hincapié, Cesar A.</creatorcontrib><creatorcontrib>Southerst, Danielle</creatorcontrib><creatorcontrib>Yu, Hainan</creatorcontrib><creatorcontrib>Bussières, André</creatorcontrib><creatorcontrib>Gross, Douglas P.</creatorcontrib><creatorcontrib>Pereira, Paulo</creatorcontrib><creatorcontrib>Mior, Silvano</creatorcontrib><creatorcontrib>Tricco, Andrea C.</creatorcontrib><creatorcontrib>Cedraschi, Christine</creatorcontrib><creatorcontrib>Brunton, Ginny</creatorcontrib><creatorcontrib>Nordin, Margareta</creatorcontrib><creatorcontrib>Connell, Gaelan</creatorcontrib><creatorcontrib>Wong, Jessica J.</creatorcontrib><creatorcontrib>Shearer, Heather M.</creatorcontrib><creatorcontrib>Lee, Joyce G. 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of occupational rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Verville, Leslie</au><au>Ogilvie, Rachel</au><au>Hincapié, Cesar A.</au><au>Southerst, Danielle</au><au>Yu, Hainan</au><au>Bussières, André</au><au>Gross, Douglas P.</au><au>Pereira, Paulo</au><au>Mior, Silvano</au><au>Tricco, Andrea C.</au><au>Cedraschi, Christine</au><au>Brunton, Ginny</au><au>Nordin, Margareta</au><au>Connell, Gaelan</au><au>Wong, Jessica J.</au><au>Shearer, Heather M.</au><au>Lee, Joyce G. B.</au><au>Wang, Dan</au><au>Hayden, Jill A.</au><au>Cancelliere, Carol</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured Exercise Programs for Chronic Primary Low Back Pain in Adults</atitle><jtitle>Journal of occupational rehabilitation</jtitle><stitle>J Occup Rehabil</stitle><addtitle>J Occup Rehabil</addtitle><date>2023-12-01</date><risdate>2023</risdate><volume>33</volume><issue>4</issue><spage>636</spage><epage>650</epage><pages>636-650</pages><issn>1053-0487</issn><eissn>1573-3688</eissn><abstract>Purpose
Evaluate benefits and harms of structured exercise programs for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline.
Methods
We searched for randomized controlled trials (RCTs) in electronic databases (inception to 17 May 2022). Eligible RCTs targeted structured exercise programs compared to placebo/sham, usual care, or no intervention (including comparison interventions where the attributable effect of exercise could be isolated). We extracted outcomes, appraised risk of bias, conducted meta-analyses where appropriate, and assessed certainty of evidence using GRADE.
Results
We screened 2503 records (after initial screening through Cochrane RCT Classifier and Cochrane Crowd) and 398 full text RCTs. Thirteen RCTs rated with overall low or unclear risk of bias were synthesized. Assessing individual exercise types (predominantly very low certainty evidence), pain reduction was associated with aerobic exercise and Pilates vs. no intervention, and motor control exercise vs. sham. Improved function was associated with mixed exercise vs. usual care, and Pilates vs. no intervention. Temporary increased minor pain was associated with mixed exercise vs. no intervention, and yoga vs. usual care. Little to no difference was found for other comparisons and outcomes. When pooling exercise types, exercise vs. no intervention probably reduces pain in adults (8 RCTs, SMD = − 0.33, 95% CI − 0.58 to − 0.08) and functional limitations in adults and older adults (8 RCTs, SMD = − 0.31, 95% CI − 0.57 to − 0.05) (moderate certainty evidence).
Conclusions
With moderate certainty, structured exercise programs probably reduce pain and functional limitations in adults and older people with CPLBP.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>37991647</pmid><doi>10.1007/s10926-023-10124-4</doi><tpages>15</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1053-0487 |
| ispartof | Journal of occupational rehabilitation, 2023-12, Vol.33 (4), p.636-650 |
| issn | 1053-0487 1573-3688 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10684665 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Adults Aged Back pain Bias Clinical practice guidelines Clinical Psychology Clinical trials Environmental Health Exercise Exercise Therapy Health Psychology Humans Intervention Low back pain Low Back Pain - therapy Medicine Medicine & Public Health Motor task performance Occupational Medicine/Industrial Medicine Older people Orthopedics Pain Pilates Practice Guidelines as Topic Randomized Controlled Trials as Topic Rehabilitation Systematic Review |
| title | Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured Exercise Programs for Chronic Primary Low Back Pain in Adults |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-04T15%3A09%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Systematic%20Review%20to%20Inform%20a%20World%20Health%20Organization%20(WHO)%20Clinical%20Practice%20Guideline:%20Benefits%20and%20Harms%20of%20Structured%20Exercise%20Programs%20for%20Chronic%20Primary%20Low%20Back%20Pain%20in%20Adults&rft.jtitle=Journal%20of%20occupational%20rehabilitation&rft.au=Verville,%20Leslie&rft.date=2023-12-01&rft.volume=33&rft.issue=4&rft.spage=636&rft.epage=650&rft.pages=636-650&rft.issn=1053-0487&rft.eissn=1573-3688&rft_id=info:doi/10.1007/s10926-023-10124-4&rft_dat=%3Cproquest_pubme%3E2894579866%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2894579866&rft_id=info:pmid/37991647&rfr_iscdi=true |