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- Title
Effect of Trunk-Focused Exercises on Pain, Disability, Quality of Life, and Trunk Physical Fitness in Low Back Pain and How Potential Effect Modifiers Modulate Their Effects: A Systematic Review With Meta-analyses.
- Authors
PRAT-LURI, AMAYA; DE LOS RIOS-CALONGE, JAVIER; MORENO-NAVARRO, PEDRO; MANRESA-ROCAMORA, AGUSTÍN; VERA-GARCIA, FRANCISCO J.; BARBADO, DAVID
- Abstract
OBJECTIVE: To analyze the effect of trunk-focused exercise programs (TEPs) and moderator factors on chronic nonspecific low back pain (LBP). DESIGN: Systematic review with meta-analyses. LITERATURE SEARCH: We searched the PubMed, Scopus, Embase, SPORTDiscus, and CENTRAL databases from their inception to June 2022. STUDY SELECTION CRITERIA: We included randomized controlled trials comparing TEPs to control or general exercises.UDATA SYNTHESIS: We used random-effects models to calculate the standardized mean difference (SMD) plus confidence interval (CI) and heterogeneity (I²) for pain, disability, quality of life, and trunk performance. The impact of moderator factors was analyzed through meta-regression. RESULTS: Forty randomized controlled trials (n = 2391) were included. TEPs showed positive effects for all outcomes versus control (SMD 0.90-2.46; 95% CI, -0.04 to 4.96; I² 61%-98%). There were small effects in favor of TEPs versus general exercises for pain (SMD = 0.20; 95% CI, 0.03-0.37; I² = 13.4%) and disability (SMD = 0.20; 95% CI, 0.02-0.38; I² = 0%). Trunk and/or hip range-of-motion improvements were associated with greater reductions in pain (P<.01; β = 0.56; 95% CI, 0.25-0.87) and disability (P<.01; β = 0.66; 95% CI, 0.27-1.05). Low body mass was associated with higher pain reduction (P = .03; β = -0.17; 95% CI, -0.32 to -0.02). CONCLUSIONS: Trunk-focused exercise programs had positive effects on pain, disability, quality of life, and trunk performance compared to control groups, and on pain and disability compared to general exercises. Increasing trunk and/or hip range of motion was associated with greater pain and disability reduction, and lower body mass with higher pain reduction. J Orthop Sports
- Subjects
LUMBAR pain; CHRONIC pain; ONLINE information services; META-analysis; MEDICAL information storage &; retrieval systems; CONFIDENCE intervals; TORSO; SYSTEMATIC reviews; POSTURAL balance; PHYSICAL fitness; EXERCISE physiology; SPORTS; ACTIVITIES of daily living; QUALITY of life; DESCRIPTIVE statistics; RESEARCH funding; MEDLINE; INFORMATION storage &; retrieval systems; ABDOMINAL exercises; REHABILITATION; BACK exercises
- Publication
Journal of Orthopaedic & Sports Physical Therapy, 2023, Vol 53, Issue 2, p64
- ISSN
0190-6011
- Publication type
Article
- DOI
10.2519/jospt.2023.11091