Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Jan 3;19(1):1.
doi: 10.1186/s13018-023-04392-2.

How to tackle non-specific low back pain among adult patients? A systematic review with a meta-analysis to compare four interventions

Yawen Jiang  1   2 , Yaping Xu  3 , Xiangrui Kong  2 , En Zhao  2 , Chunxia Ma  2 , Yihang Lv  2 , Hongqi Xu  4 , He Sun  5 , Xiaojuan Gao  6   7
Affiliations
Meta-Analysis

How to tackle non-specific low back pain among adult patients? A systematic review with a meta-analysis to compare four interventions

Yawen Jiang et al. J Orthop Surg Res. .

Abstract

Objective: To tackle non-specific low back pain (NSLBP) among patients and find the most effective solution and to quantitatively synthesize the overall effect of motor control training (MCT) compared with Pilates, McKenzie method, and physical therapy (PT) in pain and physical function.

Methods: Randomized controlled trials (RCTs) of four types of intervention (MCT, Pilates, McKenzie method, and PT) for LBP were collected by searching PubMed, Web of Science, EBSCOhost (Cochrane Central Register of Controlled Trials), and Scopus databases from the establishment of the database to September 30, 2023. The risk of bias was evaluated for included studies using the Revised Cochrane Risk of Bias tool for randomized trials (RoB 2.0). Taking pain and physical function in the experimental and control groups as outcome indicators, subgroup analysis was performed according to the intervention method to calculate the standardized mean difference (SMD) and 95% confidence interval (CI).

Results: A total of 25 RCTs, including 1253 patients, were included. Meta-analysis showed that MCT effectively relieved pain [SMD = -0.65, 95% CI (- 1.00, - 0.29), p < 0.01] and improved physical function [SMD = -0.76, 95% CI (- 1.22, - 0.31), p < 0.01] comparing with other 3 types of intervention. Subgroup analysis suggested that MCT could alleviate pain [SMD = -0.92, 95% CI (- 1.34, - 0.50), p < 0.01] and improve physical function [SMD = -1.15, 95% CI (- 1.72, - 0.57), p < 0.01] compared with PT, but it had no statistical significance compared with Pilates [pain: SMD = 0.13, 95% CI (- 0.56, 0.83), p = 0.71; physical function: SMD = 0.10, 95% CI (- 0.72, 0.91), p = 0.81] and the McKenzie method [pain: SMD = -0.03, 95% CI (- 0.75, 0.68), p = 0.93; physical function: SMD = -0.03, 95% CI (- 1.00, 0.94), p = 0.95].

Conclusions: MCT can effectively relieve pain and improve physical function in patients with NSLBP. It is more effective compared with PT for LBP, while no differences were detected between MCT and Pilates, as well as McKenzie method. Therefore, MCT, Pilates, and the McKenzie method should be encouraged as exercise interventions for NSLBP rehabilitation.

Keywords: McKenzie; Motor control training; Non-specific low back pain; Physical therapy; Pilates.

PubMed Disclaimer

Conflict of interest statement

All authors have no conflicts of interest relevant to the content of this review.

Figures

Fig. 1
Fig. 1
The literature search and inclusion process of this study
Fig. 2
Fig. 2
Risk of bias assessment for each study
Fig. 3
Fig. 3
Overall risk of bias for included studies
Fig. 4
Fig. 4
Effects of MCT on pain in patients with NSLBP
Fig. 5
Fig. 5
Effects of MCT on physical function in patients with NSLBP
Fig. 6
Fig. 6
Forest plots of subgroup analysis of different interventions in the control group (pain)
Fig. 7
Fig. 7
Forest plots of subgroup analysis of different interventions in the control group (physical function)
Fig. 8
Fig. 8
Funnel plot of the effect of MCT on patients with NSLBP
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Chou R. Low back pain. Ann Intern Med. 2021;174(8):113–28. doi: 10.7326/AITC202108170. - DOI - PubMed
    1. Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP. Low back pain. Lancet. 2021;398(10294):78–92. doi: 10.1016/S0140-6736(21)00733-9. - DOI - PubMed
    1. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736–747. doi: 10.1016/S0140-6736(16)30970-9. - DOI - PubMed
    1. Collaborators GDaIIaP. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–858. - PMC - PubMed
    1. Caputo EL, Ferreira PH, Feter N, Doring IR, Leite JS, Alt R, et al. Short-term impact of COVID-19 pandemic on low back pain: data from the PAMPA Cohort, Brazil. BMC Public Health. 2023;23(1):44. doi: 10.1186/s12889-022-14932-w. - DOI - PMC - PubMed

LinkOut - more resources