Effectiveness of exercise on work disability in patients with non-acute non-specific low back pain: Systematic review and meta-analysis of randomised controlled trials.
OBJECTIVE
To determine whether exercise is more effective than usual care to reduce work disability in patients with non-acute non-specific low back pain, and if so, to explore which type of exercise is most effective.


METHODS
Systematic review and meta-analysis of randomized controlled trials investigating the effectiveness of exercise in non-acute non-specific low back pain, and reporting on work disability.


METHODS
MEDLINE, EMBASE, PEDro, Cochrane Library databases, NIOSHTIC-2, and PsycINFO until August 2008. Work disability data were converted to odds ratios. Random effects meta-analyses were conducted.


RESULTS
A total of 23 trials met the inclusion criteria, 20 of which were suitable for inclusion in meta-analysis allowing 17 comparisons of exercise interventions with usual care and 11 comparisons of 2 different exercise interventions. A statistically significant effect in favour of exercise on work disability was found in the long term (odds ratio (OR) = 0.66, 95% confidence interval (CI) 0.48-0.92) but not in the short (OR = 0.80, 95% CI 0.51-1.25) and intermediate term (OR = 0.78, 95% CI 0.45-1.34). Meta-regression indicated no significant effect of specific exercise characteristics.


CONCLUSIONS
Exercise interventions have a significant effect on work disability in patients with non-acute non-specific low back pain in the long term. No conclusions can be made regarding exercise types.
Oesch
Peter
P
Research Department, Rehabilitation Centre Valens, Valens, Switzerland. p.oesch@klinik-valens.ch
Kool
Jan
J
Hagen
Kåre Birger
KB
Bachmann
Stefan
S
D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D012050:Rehabilitation, Vocational; D016896:Treatment Outcome; D014938:Work Capacity Evaluation