Aerobic vs. resistance exercise for chronic non-specific low back pain: A systematic review and meta-analysis
Article type: Research Article
Authors: Wewege, Michael* | Booth, John | Parmenter, Belinda
Affiliations: Department of Exercise Physiology, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
Correspondence: [*] Corresponding author: Michael Wewege, Department of Exercise Physiology, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia. Tel.: +61 2 9385 5032; E-mail: m.wewege@unsw.edu.au.
Abstract: BACKGROUND/OBJECTIVE: This meta-analysis compared progressive aerobic training (PAT) to progressive resistance training (PRT) for pain, disability and quality of life (QoL) in people with chronic non-specific low back pain (CNSLBP). METHODS: Five electronic databases were systematically searched up to 1 March 2016. Randomised controlled trials included land-based PAT, PRT or combined PRT and PAT, versus usual care for CNSLBP. Exercise interventions were supervised a minimum of once per week and performed ⩾ 2 days/week for ⩾ 6 weeks. Outcome measurements were pain intensity, disability, and QoL. Standardised mean difference (SMD) and mean difference (MD) were calculated using Review Manager 5.3. RESULTS: Six studies were included, comprising 333 participants (94 PRT, 93 PAT, 146 usual care; 66% female; age = 44 ± 6 years; duration of pain = 7 ± 6 years). Exercise significantly reduced pain intensity (SMD =-0.42 [-0.80, -0.03]; p< 0.03) although neither mode proved superior. PRT significantly improved the Short Form Health Survey-Mental Component Score (SF-MCS) (MD = 5.74 [2.02, 9.47]; p= 0.002). CONCLUSIONS: PAT and PRT decreased pain intensity in individuals with CNSLBP although neither mode was superior. Resistance exercise improved psychological wellbeing. High-quality RCTs comparing PAT, PRT, and PAT + PRT, are required.
Keywords: Aerobic exercise, resistance exercise, chronic low back pain, disability, quality of life
DOI: 10.3233/BMR-170920
Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. Pre-press, no. Pre-press, pp. 1-11, 2018