SynthesisAnnals of behavioral medicine : a publication of the Society of Behavioral Medicine2026
Motivational interviewing increases physical activity for adults with low back pain: a systematic review and meta-analysis.
Synthesis in Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundLow back pain (LBP) is the leading cause of disability globally and contributes substantially to healthcare costs and lost productivity. Physical activity (PA) is recommended for managing LBP, nevertheless, many individuals with LBP remain insufficiently physically active, and strategies to support behavior change are needed. Motivational interviewing (MI) may support behavior change by enhancing intrinsic motivation and self-efficacy. PURPOSE: To synthesize evidence on the effects of MI interventions targeting PA behavior in adults with LBP.
methodsSix databases (MEDLINE, Embase, CINAHL, Web of Science, CENTRAL, PsycINFO) and clinical trial registries were searched from inception to February 2026. Eligible trials evaluated MI-based interventions targeting PA in adults with acute, subacute, or chronic LBP. Random-effects meta-analyses were conducted to calculate standardized mean differences (SMD; Hedges' g) and 95% confidence intervals (CI). The primary outcome was change in PA; secondary outcomes included pain and disability-related outcomes. Risk of bias was assessed using the Cochrane tool, and certainty of evidence was evaluated using GRADE.
resultsMotivational interviewing-based interventions were associated with a statistically significant increase in PA compared with control conditions (SMD: 0.57; 95% CI, 0.10-1.03; P = .02), representing a moderate effect. No statistically significant effects were observed for pain (SMD: 0.04; 95% CI, -0.27 to 0.36; P = .76) or disability (SMD: 0.08; 95% CI, -0.25 to 0.40; P = .60). Certainty of evidence was low for PA and very low for pain and disability outcomes.
conclusionsMotivational interviewing interventions were associated with increased PA in adults with LBP but did not demonstrate significant effects on pain or disability. MI may serve as a client-centered support strategy within broader rehabilitation models. Further high-quality trials with fidelity assessment and longer follow-up are warranted.
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