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Exercise intervention for patients with chronic low back pain: a systematic review and network meta-analysis
Network meta-analysis of 75 RCTs (5,254 participants) ranks Tai chi, yoga, and Pilates among the strongest exercise modalities for pain relief versus conventional rehabilitation or no intervention in chronic low back pain, with very wide confidence intervals and acknowledged trial-quality limits.
Design
- SR + network MA; databases through 10 May 2022
- Included: 75 RCTs, 5,254 participants comparing 20 exercise categories
Pain SMD highlights (network MA; abstract)
- Tai chi vs conventional rehabilitation: SMD −2.11 (95% CI −3.62 to −0.61)
- Tai chi vs no intervention: SMD −2.42 (95% CI −3.81 to −1.03)
- Yoga vs conventional rehabilitation / no intervention and Pilates vs conventional rehabilitation also reported with wide CIs (see tables)
Function outcomes
- Yoga and core/stabilisation exercises show SMD advantages for physical function vs conventional rehab and vs no treatment in abstract summary
Evidence hygiene
- Transitivity and small-study effects can inflate network ranks—authors caution on trial quality/quantity before definitive prescription hierarchies.
- SMD magnitudes >2 are unusually large for musculoskeletal pain—read node-specific direct evidence before quoting to patients.
Publication
Li Y, Yan L, Hou L, et al. Front Public Health. 2023 Nov 17;11:1155225. PMID 38035307.
Outcomes
- Effect Size (Cohen's d / SMD)-2.11d (Cohen's d)
- Effect Size (Cohen's d / SMD)-2.42d (Cohen's d)