Evidence map›Paper›PMID 37991647›Full record

SynthesisJournal of occupational rehabilitation2023

Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured Exercise Programs for Chronic Primary Low Back Pain in Adults.

Leslie Verville, Rachel Ogilvie, Cesar A Hincapié, Danielle Southerst, Hainan Yu, André Bussières, Douglas P Gross, Paulo Pereira, Silvano Mior, Andrea C Tricco and 10 more

Open access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of occupational rehabilitation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
3.9field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 16 citations in OpenAlex.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 10 institutions in 5 countries.

Leslie VervilleInstitute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.
Rachel OgilvieDepartment of Community Health and Epidemiology, Dalhousie University, Halifax, Canada.
Cesar A HincapiéEBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland. cesar.hincapie@uzh.ch.
Danielle SoutherstInstitute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.
Hainan YuInstitute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.
André BussièresDépartement Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières (Québec), Canada.
Douglas P GrossDepartment of Physical Therapy, University of Alberta, Edmonton, Canada.
Paulo PereiraDepartment of Neurosurgery, Centro Hospitalar Universitário São João, Faculty of Medicine, University of Porto, Porto, Portugal.
Silvano MiorInstitute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.
Andrea C TriccoLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Christine CedraschiDivision of General Medical Rehabilitation, Geneva University and University Hospitals, Geneva, Switzerland.
Ginny BruntonInstitute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.
Margareta NordinDepartment of Orthopedic Surgery and Environmental Medicine, NYU Grossman School of Medicine, New York University, New York, United States.
Gaelan ConnellInstitute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.
Jessica J WongInstitute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.
Heather M ShearerInstitute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.
Joyce G B LeeDepartment of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada.
Dan WangInstitute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada.
Jill A HaydenDepartment of Community Health and Epidemiology, Dalhousie University, Halifax, Canada.
Carol CancelliereInstitute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada. carolina.cancelliere@ontariotechu.ca.
Ontario Tech University · CACanadian Memorial Chiropractic College · CADalhousie University · CAMcGill University · CANew York University · USSt. Michael's Hospital · CAUniversidade do Porto · PTUniversity Hospital of Geneva · CHUniversity of Alberta · CAUniversity of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEvaluate benefits and harms of structured exercise programs for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline.

methodsWe searched for randomized controlled trials (RCTs) in electronic databases (inception to 17 May 2022). Eligible RCTs targeted structured exercise programs compared to placebo/sham, usual care, or no intervention (including comparison interventions where the attributable effect of exercise could be isolated). We extracted outcomes, appraised risk of bias, conducted meta-analyses where appropriate, and assessed certainty of evidence using GRADE.

resultsWe screened 2503 records (after initial screening through Cochrane RCT Classifier and Cochrane Crowd) and 398 full text RCTs. Thirteen RCTs rated with overall low or unclear risk of bias were synthesized. Assessing individual exercise types (predominantly very low certainty evidence), pain reduction was associated with aerobic exercise and Pilates vs. no intervention, and motor control exercise vs. sham. Improved function was associated with mixed exercise vs. usual care, and Pilates vs. no intervention. Temporary increased minor pain was associated with mixed exercise vs. no intervention, and yoga vs. usual care. Little to no difference was found for other comparisons and outcomes. When pooling exercise types, exercise vs. no intervention probably reduces pain in adults (8 RCTs, SMD = - 0.33, 95% CI - 0.58 to - 0.08) and functional limitations in adults and older adults (8 RCTs, SMD = - 0.31, 95% CI - 0.57 to - 0.05) (moderate certainty evidence).

conclusionsWith moderate certainty, structured exercise programs probably reduce pain and functional limitations in adults and older people with CPLBP.

Indexed as

Low Back PainAgedExerciseExercise TherapyHumansPractice Guidelines as TopicRandomized Controlled Trials as TopicExerciseLow back painMeta-analysisRehabilitationSystematic review

Identifiers

PMID37991647
PMCPMC10684665
OpenAlexW4388901135

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.