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

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.

Clinical outcomes one year after a digital musculoskeletal (MSK) program: an observational, longitudinal study with nonparticipant comparison group

“…Our pain improvement findings were consistent with previous research about the effectiveness of exercise training on decreasing chronic MSK pain [36][37][38][39][40]. For low back pain, Quentin et al's meta analysis of 13 studies reported that home-based exercise training decreased low back pain versus control groups (effect size = − 0.97, 95% CI − 1.14 to − 0.79) [36]. Skelly et al's meta analysis reported that exercise was associated with decreased back pain versus control groups at short-term (11 trials, pooled difference − 1.21 on a 0 to 10 scale, 95% CI − 1.77 to − 0.65), intermediate-term (5 trials, − 0.85, 95% CI − 1.67 to − 0.07), and long-term (1 trial, difference − 1.55, 95% CI − 2.76 to − 0.34).…”

“…Our pain improvement findings were consistent with previous research about the effectiveness of exercise training on decreasing chronic MSK pain [36][37][38][39][40]. For low back pain, Quentin et al's meta analysis of 13 studies reported that home-based exercise training decreased low back pain versus control groups (effect size = − 0.97, 95% CI − 1.14 to − 0.79) [36].…”

Sciatica. Management for family physicians

“…Lumbar spine physio-exercise program should be the first step towards recovery, by increasing fitness, strength and flexibility. [ 33 ]…”

“…Range of motion, stretching, and attention to proper posture are critical. [ 33 ] Addressing any kinetic, postural, or ergonomic issues will be a helpful adjunct. Inciting activities during prolonged sitting/standing and practicing good, erect posture are key.…”

Mesenchymal Stem Cell-Derived Exosomes as a Novel Strategy for the Treatment of Intervertebral Disc Degeneration

“…At present, IVDD therapy generally includes conservative symptomatic and surgical treatments ( Park et al, 2021 ). Conservative treatment usually exhibits good results for LBP ( van Middelkoop et al, 2011 ; Quentin et al, 2021 ). It primarily includes oral drugs (including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), skeletal muscle relaxants, acetaminophen), epidural steroid injections, and physical therapy.…”