Exercise treatment effect modifiers in persistent low back pain : an individual participant data meta-analysis of 3514 participants from 27 randomised controlled trials
Hayden, J. A., Wilson, M. N., Stewart, S., Cartwright, J. L., Smith, A. O., Riley, R. D., van Tulder, M., Bendix, T., Cecchi, F., Costa, L. O. P., Dufour, N., Ferreira, M. L., Foster, N. E., Gudavalli, M. R., Hartvigsen, J., Helmhout, P., Kool, J., Koumantakis, G. A., Kovacs, F. M., . . . Yeung, E. W. (2020). Exercise treatment effect modifiers in persistent low back pain : an individual participant data meta-analysis of 3514 participants from 27 randomised controlled trials. British Journal of Sports Medicine, 54, 1277-1278. https://doi.org/10.1136/bjsports-2019-101205
Published in
British Journal of Sports MedicineAuthors
Date
2020Copyright
© 2020 the Authors
Background: Low back pain is one of the leading causes of disability worldwide. Exercise therapy is widely recommended to treat persistent non-specific low back pain. While evidence suggests exercise is, on average, moderately effective, there remains uncertainty about which individuals might benefit the most from exercise.
Methods: In parallel with a Cochrane review update, we requested individual participant data (IPD) from high-quality randomised clinical trials of adults with our two primary outcomes of interest, pain and functional limitations, and calculated global recovery. We compiled a master data set including baseline participant characteristics, exercise and comparison characteristics, and outcomes at short-term, moderate-term and long-term follow-up. We conducted descriptive analyses and one-stage IPD meta-analysis using multilevel mixed-effects regression of the overall treatment effect and prespecified potential treatment effect modifiers.
Results: We received IPD for 27 trials (3514 participants). For studies included in this analysis, compared with no treatment/usual care, exercise therapy on average reduced pain (mean effect/100 (95% CI) −10.7 (−14.1 to –7.4)), a result compatible with a clinically important 20% smallest worthwhile effect. Exercise therapy reduced functional limitations with a clinically important 23% improvement (mean effect/100 (95% CI) −10.2 (−13.2 to –7.3)) at short-term follow-up. Not having heavy physical demands at work and medication use for low back pain were potential treatment effect modifiers—these were associated with superior exercise outcomes relative to non-exercise comparisons. Lower body mass index was also associated with better outcomes in exercise compared with no treatment/usual care. This study was limited by inconsistent availability and measurement of participant characteristics.
Conclusions: This study provides potentially useful information to help treat patients and design future studies of exercise interventions that are better matched to specific subgroups.
...
Publisher
BMJ Publishing Group Ltd.; British Association of Sport and Exercise MedicineISSN Search the Publication Forum
0306-3674Keywords
Publication in research information system
https://converis.jyu.fi/converis/portal/detail/Publication/33939245
Metadata
Show full item recordCollections
- Liikuntatieteiden tiedekunta [3077]
License
Related items
Showing items with similar title or keywords.
-
Effectiveness of Exergame Intervention on Walking in Older Adults : A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Janhunen, Maarit; Karner, Vera; Katajapuu, Niina; Niiranen, Oona; Immonen, Jaakko; Karvanen, Juha; Heinonen, Ari; Aartolahti, Eeva (Oxford University Press (OUP), 2021)Objective. The objective of this review was to systematically evaluate the effectiveness of exergaming on walking in older adults. In addition, the aim was to investigate the relationship between the exergaming effect and ... -
Exercise for the intervertebral disc : a 6-month randomised controlled trial in chronic low back pain
Owen, Patrick J.; Miller, Clint T.; Rantalainen, Timo; Simson, Katherine J.; Connell, David; Hahne, Andrew J.; Trudel, Guy; Ford, Jon J.; Belavy, Daniel L. (Springer, 2020)Background context Muscle, bone and tendon respond anabolically to mechanical forces. Whether the intervertebral disc (IVD) can benefit from exercise is unclear. Purpose To examine whether exercise can beneficially ... -
Effect of exercise for depression : systematic review and network meta-analysis of randomised controlled trials
Noetel, Michael; Sanders, Taren; Gallardo-Gómez, Daniel; Taylor, Paul; del Pozo Cruz, Borja; van den Hoek, Daniel; Smith, Jordan J; Mahoney, John; Spathis, Jemima; Moresi, Mark; Pagano, Rebecca; Pagano, Lisa; Vasconcellos, Roberta; Arnott, Hugh; Varley, Benjamin; Parker, Philip; Biddle, Stuart; Lonsdale, Chris (BMJ Publishing Group, 2024)Objective To identify the optimal dose and modality of exercise for treating major depressive disorder, compared with psychotherapy, antidepressants, and control conditions. Design Systematic review and network ... -
The Effects of Robotic Training on Walking and Functional Independence of People with Spinal Cord Injury : A Systematic Review, Meta-analysis and Meta-regression
Köyhäjoki Anna; Korpi Hilkka; Yli-Ikkelä Riku; Hakonen Harto; Kantola Mirjami; Rintala Aki; Honkanen Sari; Ilves Outi; Sjögren Tuulikki; Karvanen Juha; Aartolahti Eeva (Springer, 2024)Evidence on the effects of robotic technology is required to develop rehabilitation services. This study aimed to evaluate the effects of robot-assisted walking training on walking and functional independence in everyday ... -
Effectiveness of Robot-Assisted Lower Limb Rehabilitation on Balance in People with Stroke : A Systematic Review, Meta-analysis, and Meta-regression
Yli-Ikkelä, Riku; Rintala, Aki; Köyhäjoki, Anna; Hakonen, Harto; Korpi, Hilkka; Kantola, Mirjami; Honkanen, Sari; Ilves, Outi; Sjögren, Tuulikki; Karvanen, Juha; Aartolahti, Eeva (Springer, 2024)The objective of this study was to evaluate the effectiveness of robot-assisted lower-limb rehabilitation on balance in stroke patients and to explore the covariates associated with these effects. A systematic literature ...