Is Exercise Beneficial in Patients with Low Back Pain? - A Cochrane Review Summary with Commentary.
Frane Grubišić
PMID 36268840WHAT IT FOUND
Exercise helps chronic low back pain more than doing nothing, but the benefit is small.
It is slightly better than some other treatments like education or electrotherapy, but no better than manual therapy. The gains in pain and function did not reach the threshold for clinical importance.
Key findings
01Exercise is probably effective for chronic low back pain compared to no treatment, usual care or placebo, but the effect on functional limitations was small and did not meet the threshold for minimal clinically important difference.
02Compared to other conservative treatments, exercise showed small improvements in pain (9 points) and function (4 points) that were not considered clinically important overall.
03Subgroup analysis suggested exercise is probably more effective than advice or education alone, or electrotherapy, but showed no differences when compared with manual therapy treatments.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The authors could not make recommendations about specific types of exercise based on the results. There was insufficient reporting of adverse events in the included trials, so the safety profile of exercise treatment could not be confirmed. The review data is based on trials identified up to April 2018. While statistically significant, many of the observed effects were small and did not meet the threshold for minimal clinically important difference.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not interpret the statistical significance of exercise over other conservative treatments as a clinically meaningful advantage. The review found the average improvement in pain and function was small and did not meet the threshold for minimal clinically important difference, meaning many patients may not notice a substantial benefit compared to other active treatments.