Research Review by Dr. Shawn Thistle©

Date:

June 2005

Study Title:

Systematic review: Strategies for using exercise therapy to improve outcomes in chronic low back pain

Authors:

Hayden JA, van Tulder MW, Tomlinson G

Publication Information:

Annals of Internal Medicine 2005; 142: 776-785.

Summary:

As described in the companion paper in the same issue of this journal, exercise therapy encompasses a heterogeneous group of interventions which are effective in the treatment of chronic low back pain. Questions remain however as to the best method to deliver exercise to have the best effect.

As a follow-up to the companion paper, this systematic review was performed to identify particular exercise intervention characteristics that improve function and reduce pain in adults with non-specific low back pain.

43 trials consisting of 72 exercise treatment groups and 31 comparison groups were included in the review.

Improved pain levels and functional scores were most common in exercise programs that:
  • are individually designed and implemented in a supervised format
  • may include home exercise with therapist follow-up
  • were administered in groups or individually (with a healthcare provider)
  • were high-intensity or high-dose in nature
  • were administered in conjunction with other conservative treatments such as advice to stay active, non-steroidal anti-inflammatory medications, or manual therapy
  • consisted of stretching or muscle strengthening exercise

Conclusions & Practical Application:

This systematic review provides healthcare providers with evidence-based recommendations for implementing exercise therapy to treat chronic low back pain in adults.

Adults with non-complicated low back pain should consult a qualified health professional to have their specific case assessed, and an appropriate regimen of care, including exercise, prescribed. As always, do not begin an exercise program without proper supervision of a regulated health care professional.