The objective of this study was to systematically collate, appraise and summarise systematic reviews that assess the effects of exercise on non-specific low back pain (NSLBP). Four reviews met the inclusion criteria. Three of these achieved a low bias rating indicating a moderate/good quality review in which some/most of the SIGN criteria were fulfilled. These studies provide strong prima facie evidence that exercise programmes reduce sick leave and improve pain and disability in people with non-acute NSLBP. The clinical utility of this evidence is, however, compromised by diversity in the types of exercise interventions, cointerventions and comparison groups and the current lack of consensus on NSLBP sub-group classification and core outcomes.
Results reflect developments in the methodology of systematic reviews over the last decade. Synthesis of the findings of reviews may be facilitated by back pain research which focuses on issues relevant to contemporary theories of pain, such as strategic approaches to exercise, rather than further structural-pathological sub-classification of NSLBP.
Swinkels, Annette; Cochrane, Kirsty; Burt, Adam; Johnson, Lucy; Lunn, Thomas; Rees, Anna Sian. Exercise interventions for non-specific low back pain: an overview of systematic reviews. Physical Therapy Reviews2009, 14, 4, 247-259(13)