PMID- 38457134
OWN - NLM
STAT- MEDLINE
DCOM- 20240429
LR  - 20240429
IS  - 1938-1344 (Electronic)
IS  - 0190-6011 (Linking)
VI  - 54
IP  - 5
DP  - 2024 May
TI  - The Best Exercise Modality and Dose for Reducing Pain in Adults With Low Back 
      Pain: A Systematic Review With Model-Based Bayesian Network Meta-analysis.
PG  - 1-13
LID - 10.2519/jospt.2024.12153 [doi]
AB  - OBJECTIVE: To quantify the dose-response relationship between overall and 
      specific exercise modalities and pain, in patients with nonspecific chronic low 
      back pain (LBP). DESIGN: Systematic review with Bayesian network meta-analysis. 
      LITERATURE SEARCH: We searched the Medline, Embase, Web of Science, Cochrane 
      Library, Scopus, and SPORTDiscus databases from inception to June 2023. STUDY 
      SELECTION CRITERIA: We included randomized controlled trials of exercise 
      interventions in adults with nonspecific chronic LBP and at least 1 pain outcome 
      reported at the main trial end point. DATA SYNTHESIS: A random-effects network 
      meta-analysis was conducted. We assessed risk of bias using the Cochrane Risk of 
      Bias Tool 2.0, and used the GRADE approach to judge the certainty of evidence for 
      each outcome. RESULTS: Eighty-two trials were included (n = 5033 participants). 
      We found a nonlinear dose-response relationship between total exercise and pain 
      in patients with nonspecific chronic LBP. The maximum significant response was 
      observed at 920 MET minutes (standardized mean difference = -1.74; 95% credible 
      intervals: -2.43, -1.04). The minimal clinically important difference for 
      achieving meaningful pain improvement was 520 MET minutes per week. The dose to 
      achieve minimal clinically important difference varied by type of exercise; 
      Pilates was the most effective. The certainty of the evidence was very low to 
      moderate for all outcomes. CONCLUSION: The dose-response relationship of 
      different exercise modalities to improve pain in patients with nonspecific 
      chronic LBP had a U-shaped trajectory and low- to moderate-certainty evidence. 
      The clinical effect was most pronounced with Pilates exercise. J Orthop Sports 
      Phys Ther 2024;54(5):1-13. Epub 8 March 2024. doi:10.2519/jospt.2024.12153.
FAU - Liang, Zhide
AU  - Liang Z
FAU - Tian, Shudong
AU  - Tian S
FAU - Wang, Chuanzhi
AU  - Wang C
FAU - Zhang, Meng
AU  - Zhang M
FAU - Guo, Hengzhi
AU  - Guo H
FAU - Yu, Yingdanni
AU  - Yu Y
FAU - Wang, Xianliang
AU  - Wang X
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - J Orthop Sports Phys Ther
JT  - The Journal of orthopaedic and sports physical therapy
JID - 7908150
SB  - IM
MH  - Humans
MH  - *Low Back Pain/therapy
MH  - *Exercise Therapy/methods
MH  - *Bayes Theorem
MH  - *Network Meta-Analysis
MH  - Chronic Pain/therapy
MH  - Adult
MH  - Randomized Controlled Trials as Topic
MH  - Minimal Clinically Important Difference
OTO - NOTNLM
OT  - dose-response
OT  - exercise
OT  - model-based network meta-analysis
OT  - nonspecific chronic low back pain
OT  - pain
EDAT- 2024/03/08 12:43
MHDA- 2024/04/30 04:21
CRDT- 2024/03/08 11:33
PHST- 2024/04/30 04:21 [medline]
PHST- 2024/03/08 12:43 [pubmed]
PHST- 2024/03/08 11:33 [entrez]
AID - 10.2519/jospt.2024.12153 [doi]
PST - ppublish
SO  - J Orthop Sports Phys Ther. 2024 May;54(5):1-13. doi: 10.2519/jospt.2024.12153.