Table 3.
Summary of studies included in the systematic review, participants, and intervention characteristics.
| First Author, Year, and Country of Publication | Study Design | Participants (Baseline Sample Side and Characteristics) | Intervention | Outcomes | Results (Pre vs. Post) |
|---|---|---|---|---|---|
| Bade M et al. 2017, USA [18] | Random controlled trial | ni = 90 (37♀ and 53♂); NSLBP ≥ 2 in NPRS and disability ≥ 20% in ODI CG: ni = 43 (16♀ and 27♂, 11 dropout → nf = 32) Age (mean ± SD): 48.1 ± 2.4 y Height (mean ± SD): 1.7 ± 0.0 m Weight (mean ± SD): 78.5 ± 3.1 Kg Symptom duration (media ± SD): 19.7 ± 7.2 Wk IG: ni = 47 (21♀ and 26♂, 7 dropout → nf = 40) Age (mean ± SD): 44.8 ± 2.3 y Height (mean ± SD): 1.7 ± 0.0 m Weight (mean ± SD): 81.3 ± 4.7 Kg Symptom duration (media ± SD): 20.3 ± 6.5 Wk |
CG: MT, coordination, strengthening and resistance trunk ex., PNS mobilizations, tractions, aerobic ex., flexion ex., fitness, centralization and directional preference ex. and procedures |
Pain: NPRS Disability: ODI GROC PASS |
CG: changes from baseline ↓ NPRS (mean ± SD): 5.4 ± 0.3 vs. 1.9 ± 1.6 ↓ ODI (mean ± SD): 36.7 ± 2.1 vs. 11.9 ± 7.1 |
| GI: CG intervention + HM strengthening + hip MT (mobilization degree III-IV, 30 s/technique; A-P mobilization with traction, traction and mobilization P-A in PP) |
IG: changes from baseline ↓ NPRS (mean ± SD): 5.1 ± 0.3 vs. 1.1 ± 1.1 ↓ ODI (mean ± SD): 36.4 ± 1.5 vs. 9.1 ± 8.5 IG vs. CG ↓* NPRS (mean ± SD): 1.1 ± 1.1 vs. 1.9 ± 1.6 ↓* ODI (mean ± SD): 9.1 ± 8.5 vs. 11.9 ± 7.1 ↓* GROC (medium (1st quartile, 3rd quartile)): 6.0 (5.0, 7.0) vs. 5.0 (4.9, 6.0) ↔ PASS: yes (36 vs. 26), no (3 vs. 1), missing (6 vs. 12) |
||||
| Cai C et al. 2017, Singapore [19] | Random controlled trial, simple blind | ni = 84 (42♀ and 42♂) NSCLBP CG: -LE: ni = 28 (4 dropout → nf = 24) Age (mean ± SD): 26.1 ± 4.1 y Weight (mean ± SD): 61.7 ± 10.8 Kg BMI (mean ± SD): 21.8 ± 2.4 Kg/m2 -LS: ni = 28 (3 dropout → nf = 25) Age (mean ± SD): 26.9 ± 6.4 y Weight (mean ± SD): 60.3 ± 12.1 Kg BMI (mean ± SD): 21.9 ± 2.4 Kg/m2 IG: ni = 28 (3 dropout → nf = 25) Age (mean ± SD): 28.9 ± 5.3 y Weight (mean ± SD): 61.7 ± 12.6 Kg BMI (mean ± SD): 21.7 ± 2.4 Kg/m2 |
CG: -LE: Lumbar extensor strengthening ex. -LS: lumbopelvic motor control ex. |
Pain: NPRS Disability: PSFS LL strength: dynamometry LE resistance: EMG Activation of trunk-stabilizing muscles: US |
CG (LE and LS): changes from baseline ↓* NPRS (mean ± SD): -LE: 3.44 ± 0.87 vs. 0.76 ± 0.78 -LS: 3.62 ± 1.13 vs. 0.65 ± 0.56 ↑* PSFS (mean ± SD): -LE: 6.71 ± 0.92 vs. 8.65 ± 0.85 -LS: 6.62 ± 0.90 vs. 8.81 ± 0.80 ↑ LL strength ↑* LE resistance ↑* Activation of trunk-stabilizing muscles IG: changes from baseline ↓* NPRS (mean ± SD): 3.48 ± 1.00 vs. 0.32 ± 0.48 ↑* PSFS (mean ± SD): 6.52 ± 0.90 vs. 9.23 ± 0.65 ↑* LL strength ↑* LE resistance ↑* Activation of trunk-stabilizing muscles IG vs. CG (LE and LS) ↓* NPRS (mean ± SD): 0.32 ± 0.48 vs. 0.76 ± 0.78 and 0.65 ± 0.56 ↑* PSFS (mean ± SD): 9.23 ± 0.65 vs. 8.65 ± 0.85 and 8.81 ± 0.80 ↑ LL strength ↑* LE endurance ↔ Activation of trunk-stabilizing muscles |
| IG: HM and knee strengthening ex. | |||||
| Fukuda TY et al. 2021, Brazil [20] | Random controlled trial, simple blind | ni = 70 (37♀ and 33♂) NSCLBP CG: ni = 35 (3 dropout → nf = 32) Age (mean ± SD): 35.2 ± 12.5 y Height (mean ± SD): 1.6 ± 0.1 m Weight (mean ± SD): 72.6 ± 15.6 Kg BMI (mean ± SD): 25.3 ± 4.6 Kg/m2 Symptom duration (mean ± SD): 6.9 ± 8.1 month IG: ni = 35 (4 dropout → nf = 31) Age (mean ± SD): 40.2 ± 12.4 y Height (mean ± SD): 1.7 ± 0.1 m Weight (mean ± SD): 75.8 ± 15.9 Kg BMI (mean ± SD): 25.9 ± 5.4 Kg/m2 Symptom duration (mean ± SD): 8.1 ± 8.9 month |
CG: MT (P-A-C mobilization degree III of L1-L5, 5 reps/1 min following Maitland method and myofascial liberation) Segmentary lumbar stabilization ex. |
Pain: VAS Disability: RMDQ HM strength: dynamometry Kinematic analysis of gait (LL, trunk, and pelvis) |
CG: changes from baseline ↓ VAS (mean ± SD): 5.6 ± 2.1 vs. 2.9 ± 2.0 ↓ RMDQ (mean ± SD): 9.1 ± 4.7 vs. 4.3 ± 3.5 ↑ HM strength ↔ Kinematic analysis IG: changes from baseline ↓ VAS (mean ± SD): 5.5 ± 2.1 vs. 2.3 ± 2.2 ↓ RMDQ (mean ± SD): 8.5 ± 4.6 vs. 4.5 ± 4.4 ↑ HM strength ↔ Kinematic analysis IG vs. CG ↔ VAS (mean ± SD): 2.3 ± 2.2 vs. 2.9 ± 2.0 ↔ RMDQ (mean ± SD): 4.5 ± 4.4 vs. 4.3 ± 3.5 ↔ HM strength ↔ Kinematic analysis |
| IG: CG intervention + HM strengthening ex. | |||||
| Jeong UC et al. 2015, Korea [21] | Random controlled trial | ni = 40♀ NSLBP ≥ 5 in VAS and disability ≥ 20% in ODI CG: ni = 20♀ (0 dropout → nf = 20) Age (mean ± SD): 41.2 ± 6.7 y Height (mean ± SD): 159.9 ± 4.7 cm Weight (mean ± SD): 56.6 ± 4.2 Kg IG: ni = 20♀ (0 dropout → nf = 20) Age (mean ± SD): 41.2 ± 5.5 y Height (mean ± SD): 161.5 ± 6.0 cm Weight (mean ± SD): 59.7 ± 7.2 Kg |
CG: Lumbar stabilization ex. (2 sets/20 reps/10 s) |
Disability: ODI Lumbar strength: M3 Balance: Tetrax |
CG: changes from baseline ↓ ODI (mean ± SD) (pre–post value): 4.5 ± 2.4 ↑ Lumbar strength ↑ Balance IG: changes from baseline ↓ ODI (mean ± SD) (pre–post value): 9.9 ± 3.2 ↑Lumbar strength ↑ Balance IG vs. CG ↓* ODI (mean ± SD) (pre–post value): 9.9 ± 3.2 vs. 4.5 ± 2.4 ↑* Lumbar strength ↑* Balance |
| IG: CG intervention + HM strengthening ex. | |||||
| Kendall KD et al. 2014, Canada [22] | Random controlled trial | ni = 80 (42♀ and 38♂); NSCLBP ≥ 5 in VAS CG: ni = 40 (18♀ and 22♂, 4 dropout → nf = 36) Age (95%CI): 33 (33, 41) y Height (95%CI): 172 (169, 175) cm Weight (95%CI): 73 (68, 78) Kg Symptom duration (95%CI): 4 (3, 6) y IG: ni = 40 (24♀ and 16♂, 5 dropout → nf = 35) Age (95%CI): 41 (37, 45) y Height (95%CI): 170 (167, 173) cm Weight (95%CI): 77 (71, 83) Kg Symptom duration (95%CI): 7 (4, 10) y |
CG: Lumbopelvic motor control (transverse, multifidus and pelvic floor coordination) |
Pain: VAS Disability: ODI HM strength: dynamometry Trendelenburg Test |
CG: changes from baseline ↓* VAS (mean (95%CI)): 57 (54, 61) vs. 37 (31, 41) mm ↓* ODI (mean (95%CI)): 22 (19, 24) vs. 14 (11, 17) ↔ HM strength ↔ Trendelenburg Test IG: changes from baseline ↓* VAS (mean (95%CI)): 55 (51, 58) vs. 30 (24, 36) mm ↓* ODI (mean (95%CI)): 20 (17, 23) vs. 12 (10, 14) ↑* HM strength ↔ Trendelenburg Test IG vs. CG ↔ VAS (mean (95%CI)): 30 (24, 36) vs. 37 (31, 41) mm ↔ ODI (mean (95%CI)): 12 (10, 14) vs. 14 (11, 17) ↑* HM strength ↔ Trendelenburg test |
| IG: CG intervention + HM strengthening ex. | |||||
| Kim B and Yim 2020, Korea [23] | Randomized controlled trial, doble blind | ni = 75 (32♀ and 34♂); NSCLBP ≥ 3 in VAS CG: ni = 25 (5 dropout → nf = 20) Age (mean ± SD): 47.7 ± 8.5 y Height (mean ± SD): 167.7 ± 8.1 cm Weight (mean ± SD): 67.6 ± 8.7 Kg BMI (media ± SD): 23.9 ± 1.0 Kg/m2 IG: -SIG: ni = 25 (3 dropout → nf = 22) Age (mean ± SD): 47.0 ± 9.4 y Height (mean ± SD): 166.5 ± 2.1 cm Weight (mean ± SD): 66.0 ± 9.2 Kg BMI (mean ± SD): 23.6 ± 1.5 Kg/m2 -FIG: ni = 25 (1 dropout → nf = 24) Age (mean ± SD): 47.5 ± 9.7 y Height (mean ± SD): 164.7 ± 8.2 cm Weight (mean ± SD): 65.4 ± 10.4 Kg BMI (mean ± SD): 23.9 ± 1.6 Kg/m2 |
CG: Core stability ex. (30 min, 3 session/sem, 6 sem, 10reps/7–8sec) Placebo (light palpation of the lumbosacral region) |
Pain: VAS Disability: ODI and RMDQ HM flexibility: TTT, MTT, OT, and FAIRT Balance: OLST QoL: SF-36 |
CG: changes from baseline ↓* VAS (mean ± SD): 5.85 ± 1.16 vs. 2.92 ± 0.61 ↓* ODI (mean ± SD): 58.20 ± 5.27 vs. 36.70 ±5.12 ↓* RMDQ (mean ± SD): 11.40 ± 2.28 vs. 5.55 ± 1.82 ↑* HM flexibility ↑* OLST ↑* SF-36 SIG and FIG: changes from baseline ↓* VAS SIG (mean ± SD): 6.12 ± 1.02 vs. 2.37 ± 0.69 FIG (mean ± SD): 5.95 ± 1.09 vs. 2.37 ± 0.67 ↓* ODI SIG (mean ± SD): 56.91 ± 6.92 vs. 30.18 ± 7.66 FIG (mean ± SD): 57.67 ± 6.50 vs. 29.25 ± 7.66 ↓* RMDQ SIG (mean ± SD): 11.23 ± 2.62 vs. 3.54 ± 1.59 FIG (mean ± SD): 11.29 ± 1.85 vs. 3.58 ± 1.35 ↑* HM flexibility ↑* OLST ↑* SF-36 SIG vs. CG ↓* VAS (mean ± SD): 2.37 ± 0.69 vs. 2.92 ± 0.61 ↓* ODI (mean ± SD): 30.18 ± 7.66 vs. 36.70 ± 5.12 ↓* RMDQ (mean ± SD): 3.54 ± 1.59 vs. 5.55 ± 1.82 ↔ HM flexibility ↑* OLST ↑* SF-36 FIG vs. CG ↓* VAS (mean ± SD): 2.37 ± 0.67 vs. 2.92 ± 0.61 ↓* ODI (mean ± SD): 29.25 ± 7.66 vs. 36.70 ± 5.12 ↓* RMDQ (mean ± SD): 3.58 ± 1.35 vs. 5.55 ± 1.82 ↑* HM flexibility ↑* OLST ↑* SF-36 FIG vs. SIG ↔VAS (mean ± SD): 2.37 ± 0.67 vs. 2.37 ± 0.69 ↔ ODI (mean ± SD): 29.25 ± 7.66 vs. 30.18 ± 7.66 ↔ RMDQ (mean ± SD): 3.58 ± 1.35 vs. 3.54 ± 1.59 ↑* HM flexibility ↔ OLST ↔ SF-36 |
| IG: -SIG: core stability ex. + HM strengthening ex. FIG: core stability ex. + HM static stretching ex. | |||||
| Lee SW et al. 2014, Korea [24] | Randomized controlled trial | ni = 78 CLBP CG: ni = 31 (6 dropout → nf = 25) -CGLS: ni = 20 (4 dropout → nf = 16) Age (mean ± SD): 50.0 ± 11.4 y Height (mean ± SD): 161.9 ± 7.7 cm Weight (mean ± SD): 60.9 ± 9.8 Kg BMI (mean ± SD): 23.2 ± 2.8 Kg/m2 -CGIN: ni = 11 (2 dropout → nf = 9) Age (mean ± SD): 59.3 ± 17.3 y Height (mean ± SD): 161.0 ± 8.3 cm Weight (mean ± SD): 59.5 ± 10.0 Kg BMI (mean ± SD): 22.8 ± 2.9 Kg/m2 IG: ni = 47 (3 dropout → nf = 44) -IGLS: ni = 25 (2 dropout → nf = 23) Age (mean ± SD): 54.9 ± 10.6 y Height (mean ± SD): 161.0 ± 7.1 cm Weight (mean ± SD): 61.9 ± 9.8 Kg BMI (mean ± SD): 23.8 ± 2.8 Kg/m2 -IGIN: ni = 22 (1 dropout → nf = 21) Age (mean ± SD): 61.0 ± 13.2 y Height (mean ± SD): 159.7 ± 6.0 cm Weight (mean ± SD): 59.4 ± 8.9 Kg BMI (mean ± SD): 23.3 ± 2.6 Kg/m2 |
CG: Lumbar stability ex. (4 ex./4 sets/4 reps/ 10 s, 30 s rest) |
Pain: VAS Disability: modified ODI |
CG: changes from baseline ↓* VAS CGLS (mean ± SD): 55.30 ± 10.70 vs. 45.6 ± 10.30 CGIN (mean ± SD): 61.00 ± 10.00 vs. 27.60 ± 9.80 ↓* ODI CGLS (mean ± SD): 25.60 ± 12.30 vs. 21.70 ± 10.70 CGIN (mean ± SD): 30.60 ± 18.80 vs. 18.30 ± 11.10 IG: changes from baseline ↓* VAS IGLS (mean ± SD): 55.70 ± 8.90 vs. 39.60 ± 7.50 IGIN (mean ± SD): 58.90 ± 8.60 vs. 43.3 ± 12.00 ↓* ODI IGLS (mean ± SD): 23.80 ± 10.50 vs. 17.50 ± 8.10 IGIN (mean ± SD): 25.9 ± 15.80 vs. 19.80 ± 12.10 IG vs. CG ↓ VAS ↓ ODI |
| IG: CG intervention + HM strengthening ex. + hip mobility ex. |
Abbreviations: ↓: decrease; ↑: increase; ↔: without change; *: statistically significant change (p < 0,05); ni: initial sample side; nf: final sample side; ♀: women; ♂: men; CG: control group; IG: intervention group; SD: Standard Deviation; m: meters; Kg: kilograms; Wk: week; y: year; cm: centimeter; BMI: body mass index; NSLBP: non-specific low back pain; NSCLBP: non-specific chronic low back pain; CLBP: chronic low back pain; NPRS: Numeric Pain Rating Scale; ODI: Oswestry Disability Index; MT: manual therapy; ex.: exercise; PNS: peripheral nervous system; HM: hip muscles; A-P: antero-posterior; P-A: postero-anterior; PP: prone position; GROC: Global Rating of Change; PASS: patient acceptable symptom state; LE: lumbar extensor; LS: lumbar stability; PSFS: patient-specific functional scale; LL: lower limb; EMG: electromyography; US: ultrasound; P-A-C: postero-anterior-central; L1: first lumbar vertebra; L5: fifth lumbar vertebra; reps: repetitions; min: minutes; RMDQ: Roland–Morris Disability Questionnaire; VAS: Visual Analogue Scale; s: second; CI: confidence interval; SIG: strength intervention group; FIG: flexibility intervention group; TTT: toe touch test; MTT: Modified Thomas Test; OT: Ober test; FAIRT: Flexion adduction internal rotation test; OLST: one-leg standing test; QoL: quality of life; IN: lumbar instability.