Posterior-Chain Resistance Training Compared to General Exercise and Walking Programmes for the Treatment of Chronic Low Back Pain in the General Population: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 33683497 · doi:10.1186/s40798-021-00306-w
What was done
A systematic review and meta-analysis of randomized controlled trials searched four electronic databases through August 2020. The authors evaluated posterior-chain resistance training (PCRT, ≥6 weeks targeting thoracic, lumbar, and hip extensors) compared to general exercise (GE) for chronic low back pain in recreationally active and sedentary adults. Quality was appraised with the Joanna Briggs Institute tool, pooling standardized mean differences (SMD) and risk differences (RD).
What was found
Eight RCTs involving 408 participants (203 PCRT, 205 GE) were included. Compared to GE, PCRT showed: - Greater pain reduction: SMD = -0.61 (95% CI -1.21 to 0.00, p = 0.05; I² = 74%) - Greater disability reduction: SMD = -0.53 (95% CI -0.97 to -0.09, p = 0.02; I² = 52%) - Greater muscle strength increase: SMD = 0.67 (95% CI 0.21 to 1.13, p = 0.004; I² = 0%) - No difference in adverse events: RD = -0.02 (95% CI -0.10 to 0.05, p = 0.57; I² = 72%) Greater improvements were noted with 12–16 weeks versus 6–8 weeks of training.
Why it matters
Posterior-chain resistance training offers clinically meaningful benefits over general exercise for pain, disability, and strength in chronic low back pain without increasing adverse event risk.
Limits
The total sample size was small (8 studies, 408 total participants). Statistical heterogeneity was high for pain (I² = 74%) and adverse events (I² = 72%), and moderate for disability (I² = 52%). The comparative efficacy of specific movement patterns (e.g., deadlift vs. hip lift) was not evaluated.
Cited by
- supports Studies demonstrate that resistance training decreases lower back pain.