Monday 14 June 2010, 11:59AM
PEARLS No. 254, May 2010, written by Brian R McAvoy
Clinical question
How effective are exercises for prevention of recurrences of
low-back pain?
Bottom line
There was moderate quality evidence post-treatment exercises
(provided to patients after their regular treatment for an episode
of low-back pain had been finished) were more effective than no
intervention for reducing the rate of recurrences at 1 year. There
was moderate quality evidence from 2 studies that the number of
recurrences was significantly reduced at 6 months to 2 years'
follow-up. There was very low quality evidence the days on sick
leave were reduced by post-treatment exercises at 6 months to 2
years' follow-up. There was conflicting evidence for the
effectiveness of treatment exercise (exercise as part of treatment
for a current episode of low-back pain with the aim to also prevent
new episodes of low-back pain) in reducing the number of
recurrences or the recurrence rate.
Caveat
Adverse effects of exercising were not mentioned in any of the
studies. Limitations of this review include the difference in
exercises used across studies, thus making it difficult to specify
the content of such a programme to prevent low-back pain
recurrences.
Context
Low-back pain is a common disorder that has a tendency to recur.
Episodes of low-back pain can be very debilitating and impose a
heavy burden of cost internationally.
Cochrane Systematic Review
Choi BKL et al. Exercises for prevention of recurrences of low-back
pain. Cochrane Reviews 2010, Issue 1. Article No CD006555.
DOI:10.1002/14651858.CD006555.pub2. This review contains 9 studies
involving 1520 participants.