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Meta-Analysis
. 2021 Aug 10;18(16):8430.
doi: 10.3390/ijerph18168430.

Effect of Home Exercise Training in Patients with Nonspecific Low-Back Pain: A Systematic Review and Meta-Analysis

Chloé Quentin  1 , Reza Bagheri  2 , Ukadike C Ugbolue  3 , Emmanuel Coudeyre  4 , Carole Pélissier  5   6 , Alexis Descatha  7   8 , Thibault Menini  9 , Jean-Baptiste Bouillon-Minois  10 , Frédéric Dutheil  11
Affiliations
Meta-Analysis

Effect of Home Exercise Training in Patients with Nonspecific Low-Back Pain: A Systematic Review and Meta-Analysis

Chloé Quentin et al. Int J Environ Res Public Health. .

Abstract

Background: Exercise therapy is recommended to treat non-specific low back pain (LBP). Home-based exercises are promising way to mitigate the lack of availability of exercise centers. In this paper, we conducted a systemic review and meta-analysis on the effects of home-based exercise on pain and functional limitation in LBP.

Method: PubMed, Cochrane, Embase and ScienceDirect were searched until April 20th, 2021. In order to be selected, studies needed to report the pain and functional limitation of patients before and after home-based exercise or after exercise both in a center and at-home. Random-effect meta-analyses and meta-regressions were conducted.

Results: We included 33 studies and 9588 patients. We found that pain intensity decreased in the exclusive home exercise group (Effect size = -0.89. 95% CI -0.99 to -0.80) and in the group which conducted exercise both at-home and at another setting (-0.73. -0.86 to -0.59). Similarly, functional limitation also decreased in both groups (-0.75. -0.91 to -0.60, and -0.70, -0.92 to -0.48, respectively). Relaxation and postural exercise seemed to be ineffective in decreasing pain intensity, whereas trunk, pelvic or leg stretching decreased pain intensity. Yoga improved functional limitation. Supervised training was the most effective method to improve pain intensity. Insufficient data precluded robust conclusions around the duration and frequency of the sessions and program.

Conclusion: Home-based exercise training improved pain intensity and functional limitation parameters in LBP.

Keywords: lumbalgia; musculoskeletal disorders; physical activity; prevention; public health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Meta-analysis on the effect of home-based exercise on functional limitation, stratified by setting (exclusive home-based training versus home-based and other setting).
Figure A2
Figure A2
Summary of meta-analysis on the effect of home-based exercise on pain intensity and functional limitation, stratified by setting (exclusive home-based training versus home-based and other settings), supervision, and standardization of training), using only the median time of follow-up.
Figure A3
Figure A3
Metaregressions (i.e., putative influencing variables on pain intensity and functional limitation following home-based exercise in LBP), using only the median time of follow-up.
Figure A4
Figure A4
Summary of meta-analysis on the effect of home-based exercise on pain intensity and functional limitation, stratified by setting (exclusive home-based training versus home-based and other settings, supervision, and standardization of training), using only the last time of follow-up.
Figure A5
Figure A5
Metaregressions (i.e., putative influencing variables on pain intensity and functional limitation following home-based exercise in LBP), using only the last time of follow-up.
Figure A6
Figure A6
Funnel plot (meta-funnel) for effect size of home-based exercise on pain intensity and functional limitation, in low back pain. Each dot represents a single study, with its corresponding effect size (x-axis) and its associated standard error of the effect estimate (y-axis). Large high-powered studies are placed towards the top, and smaller low-powered studies towards the bottom. The plot should ideally resemble a pyramid or inverted funnel, with scatter due to sampling variation. Studies outside the funnel plot are likely to present bias.
Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
Summary of methodological qualities of included studies using the SIGN checklist.
Figure 3
Figure 3
Summary of meta-analysis on the effect of home-based exercise on pain intensity and functional limitation, stratified by setting (exclusive home-based training versus home-based and other setting), supervision, and standardization of training.
Figure 4
Figure 4
Meta-analysis on the effect of home-based exercise on pain intensity, stratified by setting (exclusive home-based training versus home-based and other setting).
Figure 5
Figure 5
Metaregressions i.e., putative influencing variables on pain intensity and functional limitation following home-based exercise in LBP.
See this image and copyright information in PMC

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