DOSage of Exercise for chronic low back pain disorders (DOSE): protocol for a systematic review with dose-response network meta-analysis

Nitin Kumar Arora^{1

2}, Lars Donath², Patrick J Owen^{3

4}, Clint T Miller⁵, Svenja Kaczorowski^{1

2}, Tobias Saueressig⁶, Hugo Pedder⁷, Niamh L Mundell⁵, Scott D Tagliaferri^{8

9}, Ashish Diwan¹⁰, Xiaolong Chen¹⁰, Xiaohui Zhao¹¹, Eva-Maria Huessler¹², Katja Ehrenbrusthoff¹, Jon J Ford^{13

14}, Andrew J Hahne¹³, Ludwig Hammel¹⁵, Heike Norda¹⁶, Daniel L Belavy¹

Affiliations

¹ Hochschule für Gesundheit, Department of Applied Health Sciences, Division of Physiotherapy, University of Applied Sciences, Bochum, Germany.
² Department of Intervention Research in Exercise Training, German Sport University Cologne, Koln, Germany.
³ Eastern Health Emergency Medicine Program, Melbourne, Victoria, Australia.
⁴ Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.
⁵ Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
⁶ Physio Meets Science GmbH, Leimen, Germany.
⁷ Population Health Sciences, University of Bristol, Bristol, UK.
⁸ Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.
⁹ Orygen Ltd, Parkville, Victoria, Australia.
¹⁰ St. George Hospital, Department of Orthopaedic Surgery, Spine Service, University of New South Wales, Sydney, New South Wales, Australia.
¹¹ Xi'an University of Architecture & Technology, Beilin, China.
¹² Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany.
¹³ Discipline of Physiotherapy, School of Allied Health, Human Services & Sport, La Trobe University, Bundoora, Victoria, Australia.
¹⁴ Advance Healthcare, Victoria, Victoria, Australia.
¹⁵ Deutsche Vereinigung Morbus Bechterew e.V. (DVMB), 97421 Schweinfurt, Germany.
¹⁶ UVSD SchmerzLOS e.V. (Unabhängige Vereinigung aktiver Schmerzpatienten in Deutschland), 24534 Neumünster, Germany.

PMID: 39161554
PMCID: PMC11331831
DOI: 10.1136/bmjsem-2024-002108

DOSage of Exercise for chronic low back pain disorders (DOSE): protocol for a systematic review with dose-response network meta-analysis

Nitin Kumar Arora et al. BMJ Open Sport Exerc Med. 2024.

. 2024 Aug 16;10(3):e002108.

doi: 10.1136/bmjsem-2024-002108. eCollection 2024.

Authors

Affiliations

¹ Hochschule für Gesundheit, Department of Applied Health Sciences, Division of Physiotherapy, University of Applied Sciences, Bochum, Germany.
² Department of Intervention Research in Exercise Training, German Sport University Cologne, Koln, Germany.
³ Eastern Health Emergency Medicine Program, Melbourne, Victoria, Australia.
⁴ Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.
⁵ Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
⁶ Physio Meets Science GmbH, Leimen, Germany.
⁷ Population Health Sciences, University of Bristol, Bristol, UK.
⁸ Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.
⁹ Orygen Ltd, Parkville, Victoria, Australia.
¹⁰ St. George Hospital, Department of Orthopaedic Surgery, Spine Service, University of New South Wales, Sydney, New South Wales, Australia.
¹¹ Xi'an University of Architecture & Technology, Beilin, China.
¹² Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany.
¹³ Discipline of Physiotherapy, School of Allied Health, Human Services & Sport, La Trobe University, Bundoora, Victoria, Australia.
¹⁴ Advance Healthcare, Victoria, Victoria, Australia.
¹⁵ Deutsche Vereinigung Morbus Bechterew e.V. (DVMB), 97421 Schweinfurt, Germany.
¹⁶ UVSD SchmerzLOS e.V. (Unabhängige Vereinigung aktiver Schmerzpatienten in Deutschland), 24534 Neumünster, Germany.

PMID: 39161554
PMCID: PMC11331831
DOI: 10.1136/bmjsem-2024-002108

Abstract

Chronic low back disorders are the leading cause of direct and indirect healthcare burden globally. Exercise training improves pain intensity, mental health and physical function. However, the optimal prescription variables are unknown. We aim to compare the efficacy of various exercise dosages for chronic low back disorders to identify the optimal prescription variables. Six databases (Medline, SPORTDiscus, CINAHL, PsycINFO, EMBASE and CENTRAL), trial registries (ClinicalTrials.gov and WHO International Clinical Trials Registry Platform) and reference lists of prior systematic reviews will be searched, and we will conduct forward and backward citation tracking. We will include peer-reviewed randomised controlled trials (individual, cluster or cross-over trials) published in English or German language comparing exercise training to other exercise training or non-exercise training interventions (conservative, non-surgical, non-pharmacological, non-invasive treatments, placebo, sham, usual/standard care, no-treatment control, waitlist control) in adults with chronic low back disorders. Outcomes will include pain intensity, disability, mental health, adverse events, adherence rate, dropout rate and work capacity. Version 2 of the Cochrane risk-of-bias tool will be employed. The dose will be categorised as cumulative dose (total and weekly minutes of exercise training) and individual dose prescription variables (intervention duration, session duration, frequency and intensity). Dose-response model-based network meta-analysis will be used to assess the comparative efficacy of different exercise doses to determine a dose-response relationship. The certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation. Information about optimal exercise training dosage will help in enhancing treatment outcomes.

Keywords: Back injuries; Evidence based review; Exercise rehabilitation; Meta-analysis; Physical activity.

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Conflict of interest statement

None declared.

References

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DOSage of Exercise for chronic low back pain disorders (DOSE): protocol for a systematic review with dose-response network meta-analysis

Affiliations

DOSage of Exercise for chronic low back pain disorders (DOSE): protocol for a systematic review with dose-response network meta-analysis

Authors

Affiliations

Abstract

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources