Aerobic vs. resistance exercise for chronic non-specific low back pain: A systematic review and meta-analysis

BACKGROUND/OBJECTIVE: This meta-analysis compared progressive aerobic training (PAT) to progressive resistance training (PRT) for pain, disability and quality of life (QoL) in people with chronic non-specific low back pain (CNSLBP). METHODS: Five electronic databases were systematically searched up to 1 March 2016. Randomised controlled trials included land-based PAT, PRT or combined PRT and PAT, versus usual care for CNSLBP. Exercise interventions were supervised a minimum of once per week and performed >= 2 days/week for >= 6 weeks. Outcome measurements were pain intensity, disability, and QoL. Standardised mean difference (SMD) and mean difference (MD) were calculated using Review Manager 5.3. RESULTS: Six studies were included, comprising 333 participants (94 PRT, 93 PAT, 146 usual care; 66% female; age = 44 +/- 6 years; duration of pain = 7 +/- 6 years). Exercise significantly reduced pain intensity (SMD = 0.42 [0.80, 0.03]; p < 0.03) although neither mode proved superior. PRT significantly improved the Short Form Health Survey-Mental Component Score (SF-MCS) (MD = 5.74 [2.02, 9.47]; p = 0.002). CONCLUSIONS: PAT and PRT decreased pain intensity in individuals with CNSLBP although neither mode was superior. Resistance exercise improved psychological wellbeing. High-quality RCTs comparing PAT, PRT, and PAT + PRT, are required.