Therapeutic Exercise Parameters, Considerations and Recommendations for the Treatment of Non-Specific Low Back Pain: International DELPHI Study

Overview

Journal J Pers Med

Date 2023 Oct 27

PMID 37888121

Authors

Zacarias Sanchez Mila

Teresa Villa Munoz

Maria Del Rosario Ferreira Sanchez

Raul Frutos Llanes

Jose Manuel Barragan Casas

David Rodriguez Sanz

Jorge Velazquez Saornil

Affiliations

Soon will be listed here.

Abstract

Background: Therapeutic exercise (TE) recommendations for non-specific low back pain (LBP) are meant to support therapy choices for people who suffer from this condition. The aim of this study was to reach an agreement on the definition and use of TE in the care of people with LBP.

Methods: A Delphi study was carried out with a formal consensus procedure and sufficient scientific evidence, using an established methodology. Four rounds of anonymous questionnaires were administered to create useful suggestions and instructions in terms of the therapeutic activity for patients with LBP, and a group consensus conference.

Results: A consensus was reached on most of the questions after 35 physiotherapists completed the questionnaires. Participants agreed that proper TE requires correct posture, body awareness, breathing, movement control, and instruction. Patients with LBP were advised to participate in supervised sessions twice a week for 30 to 60 min for a period of 3 to 6 months. Participants added that tailored evaluation and exercise prescription, monitoring, and functional integration of exercise, as well as using specific equipment, would benefit patients with LBP.

Conclusions: TE recommendations for patients with LBP should be dosed and customized based on their personal psychological needs, level of fitness, and kinesiophobia.

Citing Articles

Evaluation of the Development, Implementation, Maintenance, and Impact of 3 Digital Surveillance Tools Deployed in Malawi During the COVID-19 Pandemic: Protocol for a Modified Delphi Expert Consensus Study.

Denny A, Ndemera I, Chirwa K, Wu J, Chirambo G, Yosefe S JMIR Res Protoc. 2024; 13():e58389.

PMID: 39740220 PMC: 11733520. DOI: 10.2196/58389.

References

Balague F, Mannion A, Pellise F, Cedraschi C . Non-specific low back pain. Lancet. 2011; 379(9814):482-91. DOI: 10.1016/S0140-6736(11)60610-7. View

Quentin C, Bagheri R, Ugbolue U, Coudeyre E, Pelissier C, Descatha A . Effect of Home Exercise Training in Patients with Nonspecific Low-Back Pain: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021; 18(16). PMC: 8391468. DOI: 10.3390/ijerph18168430. View

Kovacs F, Burgos-Alonso N, Martin-Nogueras A, Seco-Calvo J . The Efficacy and Effectiveness of Education for Preventing and Treating Non-Specific Low Back Pain in the Hispanic Cultural Setting: A Systematic Review. Int J Environ Res Public Health. 2022; 19(2). PMC: 8776076. DOI: 10.3390/ijerph19020825. View

Wall J, Meehan 3rd W, Trompeter K, Gissane C, Mockler D, van Dyk N . Incidence, prevalence and risk factors for low back pain in adolescent athletes: a systematic review and meta-analysis. Br J Sports Med. 2022; 56(22):1299-1306. DOI: 10.1136/bjsports-2021-104749. View

Hlaing S, Puntumetakul R, Khine E, Boucaut R . Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC Musculoskelet Disord. 2021; 22(1):998. PMC: 8630919. DOI: 10.1186/s12891-021-04858-6. View

Melo Cruz M, Santeularia Verges M, Rius Llorens C, Gich Saladich I, Catala Puigbo E . Influence of comorbidities on pain intensity in patients with chronic low back pain. Med Clin (Barc). 2021; 159(2):73-77. DOI: 10.1016/j.medcli.2021.09.023. View

Kostev K . Real-world prevalence and incidence of lower back pain in Germany. Rheumatol Int. 2019; 39(6):1113. DOI: 10.1007/s00296-019-04295-8. View

Eliks M, Zgorzalewicz-Stachowiak M, Zenczak-Praga K . Application of Pilates-based exercises in the treatment of chronic non-specific low back pain: state of the art. Postgrad Med J. 2019; 95(1119):41-45. PMC: 6581086. DOI: 10.1136/postgradmedj-2018-135920. View

Ramsook R, Malanga G . Myofascial low back pain. Curr Pain Headache Rep. 2012; 16(5):423-32. DOI: 10.1007/s11916-012-0290-y. View

10.

Villatoro-Luque F, Rodriguez-Almagro D, Aibar-Almazan A, Fernandez-Carnero S, Pecos-Martin D, Ibanez-Vera A . In non-specific low back pain, is an exercise program carried out through telerehabilitation as effective as one carried out in a physiotherapy center? A controlled randomized trial. Musculoskelet Sci Pract. 2023; 65:102765. DOI: 10.1016/j.msksp.2023.102765. View

11.

Maher C, Underwood M, Buchbinder R . Non-specific low back pain. Lancet. 2016; 389(10070):736-747. DOI: 10.1016/S0140-6736(16)30970-9. View

12.

Fatoye F, Gebrye T, Odeyemi I . Real-world incidence and prevalence of low back pain using routinely collected data. Rheumatol Int. 2019; 39(4):619-626. DOI: 10.1007/s00296-019-04273-0. View

13.

Hayden J, Ellis J, Ogilvie R, Malmivaara A, Van Tulder M . Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021; 9:CD009790. PMC: 8477273. DOI: 10.1002/14651858.CD009790.pub2. View

14.

Vraa M, Pascoe S, Maddox D, Rhon D, Cleland J, Young J . Prevalence and extent of low back pain and low back-related disability in non-care-seeking working-age adults. Musculoskelet Sci Pract. 2022; 60:102572. DOI: 10.1016/j.msksp.2022.102572. View

15.

Gianola S, Bargeri S, Del Castillo G, Corbetta D, Turolla A, Andreano A . Effectiveness of treatments for acute and subacute mechanical non-specific low back pain: a systematic review with network meta-analysis. Br J Sports Med. 2021; 56(1):41-50. PMC: 8685632. DOI: 10.1136/bjsports-2020-103596. View

16.

Sarafadeen R, Ganiyu S, Ibrahim A, Ismail A, Akindele M, Kaka B . Effectiveness of lumbar stabilization exercise with real-time ultrasound imaging biofeedback on lumbar multifidus muscle cross-sectional area in individuals with non-specific chronic low back pain: a study protocol for a randomized controlled trial. Trials. 2022; 23(1):20. PMC: 8734067. DOI: 10.1186/s13063-021-05952-9. View

17.

Griswold D, Gargano F, Learman K . A randomized clinical trial comparing non-thrust manipulation with segmental and distal dry needling on pain, disability, and rate of recovery for patients with non-specific low back pain. J Man Manip Ther. 2019; 27(3):141-151. PMC: 6598540. DOI: 10.1080/10669817.2019.1574389. View

18.

Fleckenstein J, Floessel P, Engel T, Krempel L, Stoll J, Behrens M . Individualized Exercise in Chronic Non-Specific Low Back Pain: A Systematic Review with Meta-Analysis on the Effects of Exercise Alone or in Combination with Psychological Interventions on Pain and Disability. J Pain. 2022; 23(11):1856-1873. DOI: 10.1016/j.jpain.2022.07.005. View

19.

Lizier D, Perez M, Sakata R . Exercises for treatment of nonspecific low back pain. Rev Bras Anestesiol. 2012; 62(6):838-46. DOI: 10.1016/S0034-7094(12)70183-6. View

20.

Osborne H, Burt P . Including exercise prescription in the management of non-specific low back pain. Emerg Med Australas. 2022; 34(5):833-836. DOI: 10.1111/1742-6723.14076. View