REVIEW article
Front. Public Health
Sec. Injury Prevention and Control
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1512450
Exercise Prescription for Improving Chronic Low Back Pain in Adults: A Network Meta-Analysis
Provisionally accepted
- Harbin Sport University, Harbin, China
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Objective:This study aims to investigate the impact of various combinations of exercise prescription variables-namely type, duration, frequency, and period-on improving chronic low back pain (CLBP) in adults. The goal is to provide evidence to inform the development of exercise prescriptions for CLBP interventions.Methods: Data sources were obtained from EBSCO, PubMed, Web of Science, Embase, and Cochrane, with the search conducted up to June 30, 2024. Two independent reviewers screened the literature, extracted data, and assessed the risk of bias in the included studies. A network metaanalysis (NMA) was performed using Stata 17.0 software, and the surface under the cumulative ranking (SUCRA) was utilized to rank the effectiveness of the exercise prescription variables.Results: Significant effects were observed for durations of 15-30 minutes [SMD = -1.62, 95% CI (-2.32, -0.92)] and ≥60 minutes [SMD = -0.81, 95% CI (-1.58, -0.03)] when compared to the control group. Intervention periods of 4 weeks [SMD = -1.82, 95% CI (-3.37, -0.28)], 12 weeks [SMD = -1.18, 95% CI (-1.85, -0.51)], and ≥16 weeks [SMD = -2.75, 95% CI (-4.26, -1.24)] also resulted in significantly better outcomes compared to the control group. The intervention effect for durations of ≥16 weeks was significantly greater than that for 12 weeks [SMD = -2.17, 95% CI (-3.58, -0.47)] and 6 weeks [SMD = -2.18, 95% CI (-3.85, -0.45)]. A frequency of three sessions per week [SMD = -1.44, 95% CI (-2.09, -0.78)] demonstrated significantly superior outcomes compared to the control group. An intervention duration of 15 to 30 minutes (SUCRA = 94.6), three sessions per week (SUCRA = 87), an intervention period of ≥16 weeks (SUCRA = 95.4), and Tai Chi exercise (SUCRA = 77.4) may be the most effective approaches for improving chronic low back pain in adults.Conclusion: Tai Chi exercise, lasting 15 to 30 minutes per session, performed three times a week over an intervention period of at least 16 weeks, may represent the most effective intervention for alleviating chronic low back pain in adults. However, due to the limited number of studies included, further research is necessary to provide stronger evidence.
Keywords: Chronic low back pain, Exercise prescription, Network meta-analysis, Tai Chi, intervention effectiveness
Received: 16 Oct 2024; Accepted: 28 Apr 2025.
Copyright: © 2025 Zhao, Zhang, Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ping Zhang, Harbin Sport University, Harbin, China
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