| Author, Year, Followup,a Pain Duration, Study Quality | Intervention | Population | Function and Pain Outcomes | Other Outcomes |
|---|---|---|---|---|
Areeudomwong, 201738 3 months Duration of pain: Mean 9.0 to 10 months Fair | A. Proprioceptive Neuromuscular Facilitation (neuromuscular re-education) (n=21): 30 minute sessions 5 times/week for 4 weeks (20 total sessions) B. Attention control (education) (n=21) | A vs. B Age: 35 vs. 36 years Female: 71% vs. 76% Baseline RDQ (0-24): 4.5 vs. 4.9 Baseline NPS (0-10): 4.1 vs. 4.2 | A vs. B 3 months RDQ: 1.7 vs. 4.8, difference −3.1 (95% CI −3.9 to −2.3), p<0.001 NPS: 1.5 vs. 3.85, difference −2.31 (95% CI −3.4 to −1.2), p<0.001 | A vs. B 3 months SF-36 PCS: 53.7 vs. 44.2, difference 9.6 (95% CI 5.4 to 13.3), p<0.001 SF-36 MCS: 49.5 vs. 48.36, difference 1.2 (95% CI −3.1 to 5.4), p>0.05 GPE: 1.4 vs. 0.7, difference 0.7 (95% CI 0.2 to 1.2), p<0.01 |
Bramberg, 201737 4.2 months Duration of pain: NR Fair | A. Strength training (n=52): Five 60-minute supervised strength-training sessions over 6 weeks. B. Attention control (education) (n=55) | A vs. B Age: 47 vs. 46 vs. 44 years Female: 72% vs. 62% vs. 80% Baseline CPGS-BD (0-100): 37.6 vs. 38.6 Baseline CPGS-BP (0-100): 57.7 vs. 55.6 | A vs. B 6 months CPGS-BD: 24.8 vs. 32.8, adjusted difference −9.5 (95% CI −19.3 to 0.4), p>0.05 CPGS-BP: 41.7 vs. 50.2, adjusted difference −9.4 (95% CI −18.1 to −0.8), p<0.05 | Work absence (mean days over time period)b A vs. B -1 to 4 months: 5.0 vs. 8.9, difference −3.9 (95% CI −11.4 to 3.6) -5 to 8 months: 6.4 vs. 12.5, difference −6.1 (95% CI −15.7 to 3.5) -9 to 12 months: 9.5 vs. 9.2, difference 0.3 (95% CI −10.3 to 10.9); Proportion absent ≥1 time: 51% vs. 44%; RR 0.95 (95% CI 0.73 to 1.22) |
Costa, 200931 4 and 10 months Duration of pain: Mean 328 to 335 weeks Fair | A: Neuromuscular re-education (motor control exercise) (n=77), 12 sessions over 8 weeks B: Placebo (n=77) (detuned shortwave diathermy and detuned ultrasound) 12 sessions, two sessions/week for 4 weeks, then 1 session/week for 4 weeks | A vs. B Age: 55 vs. 53 years Female: 58% vs. 62% Baseline RDQ (0-24): 13.1 vs. 13.4 Baseline pain (0-10 VAS): 6.8 vs. 6.6 | A vs. B 4 months RDQ: 5.3 vs. 4.3, adjusted difference 1.0 (95% CI 0.3 to 1.8) Pain (0-10 VAS): 5.0 vs. 5.6, adjusted difference 1.4 (95% CI 0.3 to 2.4) 10 months RDQ: 11.4 vs. 12.3, adjusted difference −1.0 (95% CI −2.8 to 0.8) Pain: 5.0 vs. 6.3, adjusted difference −1.0 (95% CI −1.9 to −0.1) | A vs. B 4 months Global impression of recovery (−5 to +5): 1.5 vs. 0.3, adjusted difference 1.4 (95% CI 0.3 to 1.8) 10 months Global impression of recovery: 1.2 vs. −0.3, adjusted difference 1.6 (95% CI 0.6 to 2.6) |
Garcia, 201839 1.75, 4.75, and 11.75 months Duration of mean pain: Mean 36 to 48 months Good | A. McKenzie Method of Mechanical Diagnosis and Therapy (directional preference) (n=74): In addition to the supervised treatment sessions, patients were instructed to do 10–15 repetitions of exercise, three to five times per day at home. B. Placebo (n=73) (ultrasound) | A vs. B Age: 58 vs. 56 years Female: 78.4% vs. 74% Baseline PSFS (0-10): 4.0 vs. 3.9 Baseline RDQ (0-24): 13.3 vs. 14.3 Baseline NRS (0-10): 7.2 vs. 7.0 | A vs. B 4.75 months PSFS: 6.2 vs. 5.9, adjusted difference −0.1 (95% CI −0.9 to 0.7), p=0.82 RDQ: 8.3 vs. 9.9, adjusted difference −0.5 (95% CI −2.3 to 1.3), p=0.61 NRS: 4.5 vs. 5.0, adjusted difference −0.8 (95% CI −1.8 to 0.3), p=0.15 11.75 months PSFS: 5.5 vs. 6.0, adjusted difference 0.66 (95% CI −0.13 to 1.45), p=0.10 RDQ: 7.7 vs. 8.5, adjusted difference 0.5 (95% CI −1.3 to 2.3), p=0.56 NRS: 5.1 vs. 4.9, adjusted difference −0.1 (95% CI −1.0 to 1.1), p=0.88 | A vs. B 4.75 months GPE: 2.10 vs. 1.63, adjusted difference 0.65 (95% CI −0.43 to 1.74), p=0.23 11.75 months GPE: 1.6 vs. 1.3, adjusted difference 0.0 (95% CI −1.0 to 1.1), p=0.95 |
Goldby, 200632 3, 6, 12 and 24 months Duration of pain: Mean 11 to 12 years Fair | A: Neuromuscular re-education (motor control exercise) (n=84), 10 sessions over 10 weeks B: Attention control (education) (n=40) | A vs. B Age: 43 vs. 41 years Female: 68% vs. 68% Race: 80% vs. 62% Baseline ODI (0-100): 40.5 vs. 33.5 Baseline LBO (0-75): 43.9 vs. 44.0 vs. 47.6 Baseline back pain (0-100 NRS): 45.8 vs. 37.6 | 3 months ODI (0-100): 31.00 vs. 28.1, difference 2.9 (95% CI −3.89 to 9.69) LBO (0-75): 50.92 vs. 54.4, difference −3.48 (95% CI −9.67 to 2.71) Back pain (0-100 NRS): 28.81 vs. 34.4, difference −5.59 (95% CI −17.86 to 6.68) 6 months ODI: 25.81 vs. 23.9, difference 1.91 (95% CI −6.28 to 10.10) LBO: 55.42 vs. 57.85, difference −2.43 (95% CI −9.14 to 4.28) Back pain: 23.16 vs. 30.25, difference −7.09 (95% CI −20.22 to 6.04) 12 months ODI: 24.76 vs. 26.9 difference −2.14 (95% CI −10.14 to 5.86) LBO: 53.86 vs. 50.95, difference 2.91 (95% CI −4.29 to 10.11) Back pain: 29.23 vs. 30, difference −0.77 (95% CI −14.13 to 12.59) 24 months ODI: 27 vs. 27; difference 0.00 (95% CI −11.44 to 11.44) LBO: 54.7 vs. 55.2, difference −0.5 (95% CI −9.20 to 8.20) Back pain: 35.4 vs. 50.9, difference −15.50 (95% CI −33.06 to 2.06) | 3 months Nottingham Health Profile: 94.97 vs. 94.32, difference 0.65 (95% CI −36.97 to 38.27) 6 months Nottingham Health Profile: 76.3 vs. 77.50, difference −1.20 (95% CI −37.76 to 35.36) 12 months Nottingham Health Profile: 70.06 vs. 87.47 difference −17.41 (95% CI −56.12 to 21.30) 24 months Nottingham Health Profile: 82 vs. 83, difference −1.00 (95% CI −60.85 to 58.85) |
Kankaanpaa, 199933 3 and 9 months Duration of pain: Mean 7 to 9 years Fair | A. Combined exercise (exercises, stretching, relaxation, muscle function and ergonomic advice) (n=30), 24 sessions over 12 weeks B. Attention Control (n=24) (thermal therapy and minimal massage) | A vs. B Age: 40 vs. 39 years Female: 36.6% vs. 33.3% Baseline Pain and Disability Index (0-70 PDI): 13.2 vs. 9.5 Baseline back pain (0-100 mm VAS): 55.2 vs. 47.0 | 3 months Pain and Disability Index (0-70): 5.7 vs. 12.6, difference −6.9 (95% CI −11.69 to - 2.11) Back pain (0-100 VAS): 26.6 vs. 43.4; difference −16.80 (95% CI −31.12 to −2.47) 9 months Pain and Disability Index: 5.7 vs. 11.4, difference −5.7 (95% CI −11.31 to −0.09) Back pain intensity: 23.9 vs. 45.1, difference −21.20 (95% CI −32.69 to −9.71) | NR |
Mazloum, 201740 1 month Duration of pain: Mean 30.8 to 32.4 months Poor | A. Pilates (n=20): 3 days per week for 6 weeks B. Exercise (n=20): 3 days per week for 6 weeks C. Usual care (n=20) (no treatment) | A vs. B vs. C Age: 37 vs. 43 vs. 39 years Baseline ODI (0-100): 30.8 vs. 27.2 vs. 26.2 Baseline VAS (0-10): 6.8 vs. 7.2 vs. 6.5 | 1 month A vs. C ODI: 22.9 vs. 26.6, difference −3.7 (95% CI −6.8 to −0.6) VAS: 3.0 vs. 6.9, difference −3.9 (95% CI −4.8 to −3.0) B vs. C ODI: 23.1 vs. 26.6, difference −3.5 (95% CI −8.1 to 1.2) VAS: 4.8 vs. 6.9, difference -−2.1 (95% CI −3.1 to -−1.1) A vs. B | NR |
Miyamoto, 201335 4.5 months Duration of pain: Mean 5 to 6 years Fair | A. Muscle performance (Pilates) (n=43),12 sessions over 6 weeks B. Attention control (n=43) (education) | A vs. B Age: 41 vs. 38 years Female: 84% vs. 79% Baseline RDQ: 9.7 vs. 10.5 Baseline pain (0-10 VAS): 6.6 vs. 6.5 | 4.5 months RDQ (0-24): 4.5 vs. 6.7, adjusted difference −1.4 (95% CI −3.1 to 0.03) Patient-Specific Functional Scale (0-10): 6.9 vs. 6.1, adjusted difference 0.2 (95% CI −0.6 to 1.1) Pain (0-10 VAS): 4.5 vs. 5.3, adjusted difference −0.9 (95% CI −1.9 to 0.1) | 4.5 months Global impression of recovery (−5 to +5): 2.4 vs. 1.7, adjusted difference 0.7 (95% CI −0.4 to 1.8) |
Miyamoto, 2018212 4.5 and 11.5 months Duration of pain: Mean 36 to 57 months Good | A. Pilates (n=74): 1 session/week for 6 weeks (6 total sessions). Patients attended 81% of sessions. B. Pilates (n=74): 2 sessions/week for 6 weeks (12 total sessions). Patients attended 85% of sessions. C. Pilates (n=74): 3 sessions/weeks for 6 weeks (18 total sessions). Patients attended 82% of sessions. D. Usual care (n=73) (no treatment) | A vs. B. vs. C vs. D Age: 47 vs. 47 vs. 49 vs. 49 years Female: 78% vs. 70% vs. 78% vs. 76% Baseline RDQ (0-24): 11.0 vs. 12.8 vs. 10.6 vs. 12.3 Baseline PSFS (0-10): 3.7 vs. 3.8 vs. 3.9 vs. 3.6 Baseline NRS (0-10): 6.1 vs. 6.4 vs. 6.0 vs. 6.3 | A vs. D 4.5 months RDQ: 8.8 vs. 10.2, adjusted difference 0.0 (−1.7 to 1.8), p>0.05 PSFS: 5.5 vs. 6.0, adjusted difference −0.5 (−1.3 to 0.3), p>0.05 NRS: 5.0 vs. 5.4, adjusted difference −0.3 (−1.3 to 0.6), p>0.05 11.5 months RDQ: 7.3 vs. 8.9, adjusted difference 0.2 (−1.6 to 2.0), p>0.05 PSFS: 6.1 vs. 6.2, adjusted difference −0.2 (−1.0 to 0.6), p>0.05 NRS: 4.8 vs. 4.9, adjusted difference 0.1 (−0.9 to 1.0), p>0.05 B vs. D 4.5 months RDQ: 7.9 vs. 10.2, adjusted difference −2.4 (−4.1 to −0.6), p≤0.01 PSFS: 6.5 vs. 6.0, adjusted difference 0.4 (−0.4 to 1.2), p>0.05 NRS: 4.4 vs. 5.4, adjusted difference −1.0 (−2.0 to −0.1), p≤0.05 11.5 months RDQ: 7.2 vs. 8.9, adjusted difference −1.7 (−3.5 to 0.0), p>0.05 PSFS: 6.9 vs. 6.2, adjusted difference 0.5 (−0.4 to 1.3), p>0.05 NRS: 4.1 vs. 4.9, adjusted difference −0.8 (−1.8 to 0.2), p>0.05 C vs. D 4.5 months RDQ: 6.4 vs. 10.2, adjusted difference −1.7 (−3.5 to 0.1), p>0.05 PSFS: 6.7 vs. 6.0, adjusted difference 0.3 (−0.5 to 1.2), p>0.05 NRS: 4.3 vs. 5.4, adjusted difference −0.7 (−1.7 to 0.2), p>0.05 11.5 months RDQ: 5.9 vs. 8.9, adjusted difference −0.7 (−2.5 to 1.1), p>0.05 PSFS: 6.6 vs. 6.2, adjusted difference 0.0 (−0.8 to 0.8), p>0.05 NRS: 4.1 vs. 4.9, adjusted difference −0.4 (−1.4 to 0.6), p>0.05 | A vs. D 4.5 months GPE: 1.5 vs. 1.2, adjusted difference 0.5 (−0.5 to 1.6), p>0.05 SF-6D: 0.80 vs. 0.80, adjusted difference 0.01 (−0.02 to 0.03), p>0.05 11.5 months GPE: 1.6 vs. 1.9, adjusted difference −0.1 (−1.2 to 1.0), p>0.05 SF-6D: 0.81 vs. 0.80, adjusted difference 0.01 (−0.01 to 0.04), p>0.05 Mean total societal costs (SEM): 574 vs. 649, p>0.05 B vs. D 4.5 months GPE: 2.1 vs. 1.2, adjusted difference 1.5 (0.4 to 2.6), p≤0.01 SF-6D: 0.82 vs. 0.80, adjusted difference 0.02 (−0.00 to 0.05), p>0.05 11.5 months GPE: 2.1 vs. 1.9, adjusted difference 0.9 (−0.2 to 1.9), p>0.05 SF-6D: 0.83 vs. 0.80, adjusted difference 0.04 (0.01 to 0.06), p≤0.01 Mean total societal costs (SEM): 824 vs. 649 C vs. D 4.5 months GPE: 2.6 vs. 1.2, adjusted difference 1.7 (0.6 to 2.8), p≤0.01 SF-6D: 0.84 vs. 0.80, adjusted difference 0.03 (0.00 to 0.06), p≤0.05 11.5 months GPE: 2.6 vs. 1.9, adjusted difference 1.0 (−0.1 to 2.1), p>0.05 SF-6D: 0.84 vs. 0.80, adjusted difference 0.03 (0.02 to 0.07), p≤0.05 Mean total societal costs (SEM): 880 vs. 649 |
Nassif, 201134 4 months Duration of pain: NR Poor | A. Combined exercise (n=37) (stretching, stability, coordination, and muscle strengthening exercises), 24 sessions over 8 weeks B. Usual care (n=38) | A vs. B Age: 45 vs. 45 Female: 11% vs. 21% Baseline RDQ: 13.9 vs. 12.3 Baseline pain (0-10 VAS): 4.5 vs. 4.9 | 4 months RDQ (0-24): 10.0 vs. 10.6, difference −0.6 (95% CI −3.5 to 2.3) Quebec Back Pain Disability Questionnaire: 27.2 vs. 30.2, difference −3.0 (95% CI −11.7 to 5.7) Pain (0-10 NRS): 3.2 (2.3) vs. 3.5 (2.5), difference −0.3 (95% CI −1.6 to 1.0) | 4 months Dallas Pain Questionnaire anxiety and depression: 31.2 vs. 28.9, difference 2.3 (95% CI −8.2 to 12.8) |
Natour, 201436 3 months Duration of pain: >1 year Fair | A. Exercise (Pilates) (n=30), 24 sessions over 12 weeks B. Usual care (n=30) (no treatment) | A vs. B Age: 48 vs. 48 Female: 80% vs. 77% Baseline RDQ: 1.1 vs. 10.6 Baseline pain (0-10 VAS): 5.5 vs. 5.8 | 3 months RDQ (0-24): 7.0 vs. 10.7, difference −3.6, p<0.001 Pain (0-10 VAS): 4.2 vs. 5.8, difference −1.6, p<0.001 | 3 months SF-36 physical function (0-100): 65.4 vs. 59.6, difference 5.8, p=0.026 SF-36 role physical: 56.4 vs. 40.0, difference 16.4, p=0.086 SF-36 bodily pain: 52.2 vs. 43.9, difference 8.3, p=0.030 SF-36 general health: 65.2 vs. 62.1, difference 3.1, p=0.772 SF-36 mental health: 67.9 vs. 65.3, difference 2.6, p=0.243 SF-36 social functioning: 86.0 vs. 80.4, difference 5.6, p=0.09 No differences on other SF-36 subscales |
CI = confidence interval; CPGS=Von Korff Chronic Pain Grade Score; GPE = Global Perceived Effect Scale; LBO = Low Back Outcome Score; MCS = Mental Component Score; NPS= numeric pain scale; NR = not reported; NRS = Numeric Rating Scale; ODI = Oswestry Disability Index; PCS = Physical Component Score; PSFS = Patient Specific Functional Scale; RDQ = Roland-Morris Disability Questionnaire; RR = relative risk; SEM = standard error of the mean; SF-36 = Short-Form 36 questionnaire; VAS = visual analog scale
Unless otherwise noted, followup time is calculated from the end of the treatment period.
For missed work days: time period 1 (months 1-4), time period 2 (months 5-8) and time period 3 (months 9-12).
From: Results
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.