Exercises for prevention of recurrences of low-back pain.

The objective of this review was to investigate the effectiveness of exercises for preventing new episodes of low-back pain or low-back pain-associated disability. 13 articles reporting on nine studies with nine interventions were included. Four studies with 407 participants evaluated post-treatment programmes and five studies with 1113 participants evaluated exercise as a treatment modality. Four studies had a low risk of bias, one study a high risk and the remainder an unclear risk of bias.We found moderate quality evidence that post-treatment exercises were more effective than no intervention for reducing the rate of recurrences at one year. There was moderate quality evidence that the number of recurrences was significantly reduced in two studies  at one-half to two years follow-up. There was very low quality evidence that the days on sick leave were reduced by post-treatment exercises at one-half to two years follow-up.We found conflicting evidence for the effectiveness of exercise treatment in reducing the number of recurrences or the recurrence rate.

There is moderate quality evidence that post-treatment exercise programmes can prevent recurrences of back pain but conflicting evidence was found for treatment exercise. Studies into the validity of measurement of recurrences and the effectiveness of post-treatment exercise are needed.

Choi BK, Verbeek JH, Tam WW, et al. Exercises for prevention of recurrences of low-back pain. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD006555

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