Higher intensity exercise reduces disability more than lower intensity exercise in adults with chronic low back pain: A systematic review and meta‐analysis

Abstract

BackgroundIntensity is an important determinant of physiological adaptations and health benefits of exercise, but the role of exercise intensity on improving outcomes in people with chronic low back pain (CLBP) is unclear. This systematic review aimed to determine the effect of higher versus lower intensity exercise intensity on pain, disability, quality of life and adverse events in people with CLBP.MethodsSix databases and four clinical trial registries were searched from inception to 21 December 2022, for randomised controlled trials that compared two or more exercise intensities in adults with CLBP. Data were analysed using random‐effects meta‐analysis for disability and synthesised narratively for pain, quality of life and adverse events due to limited studies. Risk of bias was assessed using the Cochrane tool and certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development and Evaluations framework.ResultsFour trials (n = 214 participants, 84% male) reported across five studies were included. Higher intensity exercise reduced disability more than lower intensity exercise at end‐treatment (SMD [95% CI] = −0.39 [−0.56 to −0.22]; very low certainty) but not at 6‐month follow‐up (SMD [95% CI] = −0.20 [−0.53 to 0.13]; very low certainty). Higher intensity exercise did not reliably improve pain and quality of life more than lower intensity exercise. Adverse events did not differ between exercise intensities. All studies were at high risk of bias.ConclusionBased on very low certainty evidence from a limited number of studies, exercise intensity does not appear to meaningfully influence clinical outcomes in people with CLBP.

Latihan Intensitas Tinggi Menurunkan Nyeri pada Non-Specific Chronic Low Back Pain: Tinjauan Sistematis

“…Latihan yang dilakukan dengan intensitas yang tinggi lebih efektif dalam memperkuat otot dibandingkan dengan intensitas yang lebih rendah. 30 Pengaruh psikologis seperti motivasi dan pemberian edukasi juga dapat memberikan efek positif terhadap hasil latihan. Intervensi motivasi dan edukasi dapat membantu kepatuhan berolahraga, memiliki efek positif pada perilaku olahraga jangka panjang, meningkatkan self-efficacy dan mengurangi tingkat keterbatasan aktivitas.…”

Effects of a Physical Exercise Programme through Service-Learning Methodology on Physical Activity, Physical Fitness and Perception of Physical Fitness and Health in University Students from Spain: A Preliminary Study

“…In line with a previous work, Castillo and Giménez [ 9 ] highlighted that 42% of university students practise PA once a week, although it reduced to 24% for a frequency of at least three days a week. It is also important to differentiate the intensity of physical activity, as it has been shown that different intensities of exercise (e.g., walking, running, interval training) lead to different fitness consequences for both over- and under-training [ 10 , 11 ].…”