July Golden Research Article

Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis.

Owen, P., Miller, C., Mundell, N, et al. (2019)


This meta-analysis aimed to determine what is the most effective type of exercise for those with chronic low back pain (CLBP) in terms of pain, disability, and mental health.

For a study to be considered, participants had to complete only exercise for a total of four weeks. Exercises included resistance, stabilisation/motor control, pilates, yoga, McKenzie, flexion (controlled movements in flexion only), aerobic, water based, or multimodal (combination of exercises).


Overall, 89 trials were reviewed. The review found low certainty evidence that pilates, stabilisation/motor control, resistance training and aerobic exercise were the most effective exercise interventions compared to other exercises, as well as non-exercise comparisons.

More specifically, this review found that pilates was the most effective for pain, stabilisation/motor control for function, and aerobic for mental health.

Significant limitations for this study are noted though making these conclusions likely implausible.

The concluding recommendation is to encourage people to move more and implement strategies to help individuals stick with exercise over time. The key is to tailor the intervention to the individual.

Key Points

  • Exercise is a recommended treatment for CLBP. Current guidelines state that no one type of exercise is superior to another, and all have small to modest effects on pain and disability.
  • This network meta-analysis found that pilates had the largest effect on pain, resistance and stabilisation/motor control exercises had the largest effect on function, and aerobic exercise had the largest effect on mental health.

If you require any specific recommendations regarding back pain please contact the clinic to make an appointment with an Exercise Physiologist  or Physiotherapist for an assessment and tailored treatment program on 42608574.

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