Chronic non-specific low back pain is a global health problem with increasing incidence through the past years. It has been recognized as one of the leading causes for limitations at daily activities and absenteeism from work. The question of the most appropriate treatment method arises. Exercise is one of the most widely used types of conservative treatments for chronic non-specific low back pain. There is an increasing body of scientific literature that investigates the effectiveness of exercise in patients with chronic non-specific low back pain. To this date, the most effective type of exercise cannot be determined. The purpose of this study was to evaluate the effectiveness of exercise in chronic non-specific low back pain patients and to compare the effectiveness of different types of exercise that is used for this purpose.
A systematic literature review was conducted. Electronic databases PubMed and Cochrane Central Register of Controlled Trials were screened for studies that were published in the past 10 years. The following search words were used: (i) non-specific low back pain AND exercise AND physical activity, (ii) non-specific low back pain AND exercise, (iii) non-specific low back pain AND physical activity. We only included publically published, randomized, controlled, clinical trials in English that were investigating the effectiveness of exercise on chronic (>12 weeks) non-specific low back pain in adult population.
In total, twenty-four trials (overall including 1539 subjects) met the inclusion criteria. Twenty-one trials confirmed exercise as an effective treatment in chronic non-specific low back pain patients. Five trials compared different types of exercise; four have found no differences in the effectiveness of these types of exercises. Six trials compared exercise with other types of conservative treatment; three studies have found differences in favour of exercise, three have found no differences between exercise and compared treatment method.
Results of this systematic literature review suggest that exercise is an effective treatment method for patients with chronic non-specific low back pain. There is no evidence that one particular type of exercise is more effective than others. In comparison with other conservative treatments exercise appears to be equally or at least as effective as other conservative treatments.
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