Effects of Exercise Therapy on Patients with Low Back Pain: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 CHENWei-ye ^1,2 , WANGHui-hao ^1,2 , LIANGFei-fan ^1,2 , DENGZhen ^1,2 , WANGKuan ^1,2 , XUQin-guang ^1,2 ,  ZHANHong-sheng ^1,2

1. Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai 201203 China;
2. Institute of Traumatology and Orthopaedics, Shanghai Academy of TCM, Shanghai 201203, China;

Corresponding author：

ZHANHong-sheng, Email: shgsyjs@139.com

Keywords：

Low back pain; Exercise therapy; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20150216

Video：

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Objective To systematically review the clinical efficacy of exercise therapy for patients with low back pain. Methods We electronically searched databases including PubMed, The Cochrane Library, CNKI, WanFang Data and VIP from 2000 to September 2014 to collect randomized controlled trial (RCTs) about exercise therapy versus other therapies in the treatment of low back pain. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software. Results A total of five RCTs involving 413 patients were finally included. Compared with the control group, exercise therapy could relieve pain (MD=-0.92, 95%CI -1.32 to -0.51, P<0.000 1), and improve function activity (MD=-1.21, 95%CI -1.43 to -0.99, P<0.01). Conclusion Exercise therapy can improve low back pain and functional activity to a certain extent. Due to the limited quantity and quality of the included studies, larger scale, multicenter, high quality RCTs are needed to verify the aforementioned conclusion.

Citation： CHENWei-ye, WANGHui-hao, LIANGFei-fan, DENGZhen, WANGKuan, XUQin-guang, ZHANHong-sheng. Effects of Exercise Therapy on Patients with Low Back Pain: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(11): 1317-1321. doi: 10.7507/1672-2531.20150216 Copy

1.	Airaksinen O, Brox JI, Cedraschi C, et al. European guidelines for the management of chronic nonspecific low back pain. Eur Spine, 2006, 15(Suppl 2):192-300.
2.	Gunnar BJA. Epidemiological features of chronic low-back pain. Lancet, 1999, 14, 354(9178):581-585.
3.	李善华, 屈红林. 运动医学与运动疗法. 中国组织工程研究与临床康复, 2007, 11(45):9194-9197.
4.	励建安. 临床运动疗法学. 北京:华夏出版社, 2005:14.
5.	Chou R, Qaseem A, Snow V, et al. Diagnosis and Treatment of Low Back Pain:A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Ann Intern Med, 2007, 147(7):478-491.
6.	Mannion AF, Balague F, Pellise F, et al. Pain measurement in patients with low back pain. Nat Clin Pract Rheumatol, 2007, 3(11): 610-830.
7.	Roland M, Morris R. A study of the natural history of back pain: part I development of a reliable and sensitive measure of disability in low back pain. Spine, 1983, 8(2):141-144.
8.	何高, 张建湘, 申才良, 等. 汉译Roland-Morris功能障碍调查表评估下腰痛患者的可靠性. 中国脊柱脊髓杂志, 2005, 15(4):242-244.
9.	Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). Available at:http://www.cochranehandbook.org.
10.	刘鸣. 系统评价Meta分析设计与实施方法. 第1版. 北京:人民卫生出版社, 2011:98-99.
11.	Wajswelner H, Metcalf B, Bennell K. Clinical Pilates versus General Exercise for Chronic Low Back Pain:Randomized Trial. Med Sci Sports Exerc, 2011, 44(7):1197-1205.
12.	Garcia AN, Costa L, da Silva TM, et al. Effectiveness of Back School Versus McKenzie Exercises in Patients With Chronic Nonspecific Low Back Pain:A Randomized Controlled Trial. Physical Therapy, 2013, 93(6):729-747.
13.	Miyamoto G, Costa L, Galvanin T, et al. Efficacy of the Addition of Modified Pilates Exercises to a Minimal Intervention in Patients With ChronicLow Back Pain:A Randomized Controlled Trial. Physical Therapy, 2013, 9(3):310-320.
14.	Rydeard R, Leger A, Smith D. Pilates-Based Therapeutic Exercise: Effect on Subjects With Nonspecific Chronic Low Back Pain and Functional Disability:A Randomized Controlled Trial. J Orthop Sports Phys Ther, 2006, 36(7):472-484.
15.	Tekur P, Nagarathna R, Chametcha S, et al. A comprehensive yoga programs improves pain, anxiety and depression in chronic low back pain patients more than exercise:An RCT. Complement Ther Med, 2012, 20(3):107-118.
16.	胡永善. 下腰痛的生物力学特点及康复. 颈腰痛杂志, 2004, 25(2): 73-75.
17.	陈丽霞, 华桂茹. 下腰痛的评定及运动疗法. 中华物理医学与康复杂志, 2001, 23(3):177-178.
18.	仇瑶琴, 李树贞, 成鹏, 等. 运动疗法在下腰痛康复中的应用. 中国康复医学杂志, 2003, 18(1):55-57.
19.	纪树荣. 运动疗法技术学. 第2版. 北京:华夏出版社, 2011:1.
20.	周涛, 邱宗忠, 杨希军. 下腰痛运动疗法的应用进展. 体育科技文献通报, 2012, 20(4):125-128.
21.	Hayden JA, van Tulder MW, Malmivaara A, et al. Exercise therapy for treatment of non-specific low back pain. Cochrane Database Syst Rev, 2005, 20(3):D335.
22.	Lizier DT, Perez MV, Sakata RK. Exercises for treatment of nonspecific low back pain. Rev Bras Anestesiol, 2012, 62(6):838-846.

1. Airaksinen O, Brox JI, Cedraschi C, et al. European guidelines for the management of chronic nonspecific low back pain. Eur Spine, 2006, 15(Suppl 2):192-300.
2. Gunnar BJA. Epidemiological features of chronic low-back pain. Lancet, 1999, 14, 354(9178):581-585.
3. 李善华, 屈红林. 运动医学与运动疗法. 中国组织工程研究与临床康复, 2007, 11(45):9194-9197.
4. 励建安. 临床运动疗法学. 北京:华夏出版社, 2005:14.
5. Chou R, Qaseem A, Snow V, et al. Diagnosis and Treatment of Low Back Pain:A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Ann Intern Med, 2007, 147(7):478-491.
6. Mannion AF, Balague F, Pellise F, et al. Pain measurement in patients with low back pain. Nat Clin Pract Rheumatol, 2007, 3(11): 610-830.
7. Roland M, Morris R. A study of the natural history of back pain: part I development of a reliable and sensitive measure of disability in low back pain. Spine, 1983, 8(2):141-144.
8. 何高, 张建湘, 申才良, 等. 汉译Roland-Morris功能障碍调查表评估下腰痛患者的可靠性. 中国脊柱脊髓杂志, 2005, 15(4):242-244.
9. Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). Available at:http://www.cochranehandbook.org.
10. 刘鸣. 系统评价Meta分析设计与实施方法. 第1版. 北京:人民卫生出版社, 2011:98-99.
11. Wajswelner H, Metcalf B, Bennell K. Clinical Pilates versus General Exercise for Chronic Low Back Pain:Randomized Trial. Med Sci Sports Exerc, 2011, 44(7):1197-1205.
12. Garcia AN, Costa L, da Silva TM, et al. Effectiveness of Back School Versus McKenzie Exercises in Patients With Chronic Nonspecific Low Back Pain:A Randomized Controlled Trial. Physical Therapy, 2013, 93(6):729-747.
13. Miyamoto G, Costa L, Galvanin T, et al. Efficacy of the Addition of Modified Pilates Exercises to a Minimal Intervention in Patients With ChronicLow Back Pain:A Randomized Controlled Trial. Physical Therapy, 2013, 9(3):310-320.
14. Rydeard R, Leger A, Smith D. Pilates-Based Therapeutic Exercise: Effect on Subjects With Nonspecific Chronic Low Back Pain and Functional Disability:A Randomized Controlled Trial. J Orthop Sports Phys Ther, 2006, 36(7):472-484.
15. Tekur P, Nagarathna R, Chametcha S, et al. A comprehensive yoga programs improves pain, anxiety and depression in chronic low back pain patients more than exercise:An RCT. Complement Ther Med, 2012, 20(3):107-118.
16. 胡永善. 下腰痛的生物力学特点及康复. 颈腰痛杂志, 2004, 25(2): 73-75.
17. 陈丽霞, 华桂茹. 下腰痛的评定及运动疗法. 中华物理医学与康复杂志, 2001, 23(3):177-178.
18. 仇瑶琴, 李树贞, 成鹏, 等. 运动疗法在下腰痛康复中的应用. 中国康复医学杂志, 2003, 18(1):55-57.
19. 纪树荣. 运动疗法技术学. 第2版. 北京:华夏出版社, 2011:1.
20. 周涛, 邱宗忠, 杨希军. 下腰痛运动疗法的应用进展. 体育科技文献通报, 2012, 20(4):125-128.
21. Hayden JA, van Tulder MW, Malmivaara A, et al. Exercise therapy for treatment of non-specific low back pain. Cochrane Database Syst Rev, 2005, 20(3):D335.
22. Lizier DT, Perez MV, Sakata RK. Exercises for treatment of nonspecific low back pain. Rev Bras Anestesiol, 2012, 62(6):838-846.

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