Table 3. Overview of included studies that evaluated the effectiveness of aerobic exercise alone intervention.

Study and subjects	Intervention	Measurements	Key outcomes	Mean change in percentage (absolute value change) pain	Mean change in percentage (absolute value change) disability	Key limitations
Kanitz et al. 43 14 patients, Aged: 30-50 years	• Group 1 (LG): Received aerobic exercise on land. • Group 2 (AG): Received aerobic exercise in deep water. • Aerobic exercise included walking/running at moderate intensity (85-95% HRvt2) for 35 mins. • Duration: 12 weeks (Two times a week).	• Pain (VAS) • Disability (ODI) • Measurements were done at baseline and after the intervention	✓ Improvements in pain and disability score were observed in both groups without any difference between groups.	Scale: VAS (100 mm) After intervention (12 weeks): LG: −66.67% (−3.8) AG: −47.27% (−2.6)	Scale: ODI (0-100) After intervention (12 weeks): LG: −40.59% (−4.1) AG: −48% (−4.8)	▪ Small sample size. ▪ Low frequency of training. ▪ No long-term follow-up.
Bello and Adeniyi 49 50 patients, Aged: 18-60 years	• Group 1 (LSG): Received lumbar stabilization exercises following the McGill protocol (30 minutes session). • Group 2 (WG): Received treadmill walking exercise (at 65%-80% HRR). • Duration: 8 weeks (three times a week).	• Pain intensity (VAS). • Functional disability (ODI). • Measurements were done at baseline and after the intervention.	✓ Significant improvements in pain intensity and disability in both groups were observed. ✓ LSG showed significantly greater improvements in all parameters than WG.	Scale: VAS (0-10 cm) After intervention (8 weeks): LSG: −59.4% (−3.8) WG: −32.8% (−2.2)	Scale: ODI (0-100) After intervention (8 weeks): LSG: −48.9% (−23.1) WG: −14.4% (−6.7)	▪ EMG activity of muscles could not be measured by using needle insertion. ▪ No long-term follow-up. ▪ Short duration of intervention.
Chulliyil et al. 45 30 patients, Aged: 18-45 years	• Group 1 (TG): Received aerobic exercise by treadmill walking. • Group 2 (SCG): Received aerobic exercise by stationary cycling. • Aerobic exercise was at moderate intensity (13-14 RPE) for 10-20 mins. • Duration: 4 weeks (5 days/week).	• Pain intensity at rest and on activity (NRS) • Disability (modified ODI) • Measurements were done at baseline and after the intervention.	✓ Both groups showed significant improvements in all measurements without any significant differences between groups.	Scale: NRS (0-10 point) After intervention (4 weeks): At rest: TG: −80.1% (−2.94) SCG: −69.3% (−2.86) On activity: TG: −55.4% (−3.73) SCG: −45.3% (−3.2)	Scale: ODI (0-100) After intervention (4 weeks): TG: −53.8% (−24.53) SCG: −49.8% (−26.4)	▪ Very short duration of intervention. ▪ Man and woman participants were not the same in number. ▪ No follow-up was done.
Hurley et al. 44 246 patients, Aged: 18-65 years	• Group 1 (WG): Received supervised walking exercise (minimum 10 min to 30 min walk/day at 40-60% HRR, for at least 4 days per week for 7 weeks. • Group 2 (ECG): Received group exercise class (Back to fitness program, a one-hour long class per week for 8 weeks.) and exercise including warm-up and stretching. • Group 3 (UG): Usual physiotherapy (education, exercise therapy, and manipulative therapy). • Duration: 8 weeks	• Pain (NRS 0-10) • Functional disability (ODI) • Measurements were done at baseline and at 3, 6, and 12 months after randomization.	✓ Significant improvements were observed in all three groups, with no significant differences between groups at all time points. ✓ No difference in the efficacy of all three programs. ✓ WG had the greatest adherence ✓ WG had the lowest costs.	Scale: NRS (0-10) At 3 months: WG: −17.8% (−0.97) ECG: −7.6% (−0.43) UG: −19.3% (−1.16) At 6 months: WG: −20.9% (−1.14) ECG: −9.4% (−0.53) UG: −15.8% (−0.95) At 12 months: WG: −21.4% (−1.17) ECG: −11% (−0.62) UG: −18.1% (−1.09)	Scale: ODI (0-100) At 3 months: WG: −12.8% (−4.45) ECG: −13% (−4.95) UG: −18% (−5.98) At 6 months: WG: −19.8% (−6.89) ECG: −15.5% (−5.91) UG: −15.3% (−5.09) At 12 months: WG: −18.7% (−6.51) ECG: −21% (−8) UG: −14.8% (−4.91)	▪ Lack of blinding of therapists and patients. ▪ Treating therapists were high in number.
Eadie et al. 58 60 patients, Aged: 18-70 years	• Group 1 (WG): Received walking exercise (30 mins at moderate intensity, 5 days per week). (Pedometer was used to record the progress) • Group 2 (SG): Received supervised exercise class (back to fitness program, once per week). • Group 3 (PG): Received usual physiotherapy (advice, manual therapy, and exercise) • Duration: 8 weeks.	• Pain (NRS) • Disability (ODI) • Measurements were done baseline, 3 months, and 6 months.	✓ Greater pain intensity and disability improvements were observed in PG than WG and SG in all time points.	Scale: NRS (0-10) At 3 months: WG: −12.1% (−0.68) SG: −12.9% (−0.68) PG: −32% (−1.96) At 6 months: WG: +1.79% (+0.1) SG: −18.9% (1) PG: −33.9% (−2.08)	ODI (0-100) At 3 months: WG: −9.4% (−3.35) SG: −22% (−7.14) PG: −27.3% (−9.06) At 6 months: WG: −6.9% (−2.47) SG: −6.2% (−2) PG: −16.7% (−5.53)	▪ Small sample size. ▪ High drop-out rate during the follow-up period.
Shnayderman and Katz-Leurer 54 52 patients, Aged: 18-65 years	• Group 1 (WG): Received walking exercise on a treadmill (at 50% heart rate reserve, 40 min session, 2 sessions per week). • Group 2 (SG): specific low back strengthening exercises (2 times per week). • Duration: 6 weeks.	• Disability (ODI) • Measurements were done at baseline and after the intervention.	✓ Both groups showed significant improvements in all outcomes. ✓ No significant differences between groups.	Did not measure	Scale: ODI (0-100) After intervention (6 weeks): EG: −34.3% (−11.8) CG: −30.6% (−8.4)	▪ The participants were not classified and divided into groups according to sign and symptoms. ▪ Short study duration.
Murtezani et al. 59 101 patients, Aged: 18-65 years	• EG: Received high-intensity aerobic exercise including treadmill walking, stair climbing, and stationary bicycling (at 50%-85% HRR, 30-50 mins sessions, three sessions per week). • CG: Passive modalities including interferential current, TENS, ultrasound, heat. (45 min session, three times per week) • Duration: 12 weeks.	• Pain intensity (VAS) • Disability (ODI) • Measurements were done at baseline and after the intervention.	✓ The experimental group showed significant improvements in all parameters. ✓ Improvements in the control group were not significant	Scale: VAS (0-10 cm) After intervention (12 weeks): EG: −66.7% (−4) CG: −1.6% (−0.1)	Scale: ODI (0-100) After intervention (12 weeks): EG: −49% (−15.2) CG: −0.3% (−0.1)	▪ No long-term follow-up was done. ▪ Not single or double-blinded.
Kell and Asmundson 56 27 patients, Aged: >18 years	• RT group: Received periodized resistance training. • AT group: Received periodized progressive overload aerobic training (elliptical trainer and treadmill walking and jogging. 20-35 min session, 3 sessions per week). • CG: Maintained normal activity. • Duration: Total 14 weeks of exercise. (2 phases, 7 weeks per phase)	• Pain (VAS) • Disability (ODI) • Measurements were recorded at baseline, at 8 weeks, and at 16 weeks.	✓ RT groups – Significant improvement in pain, disability. ✓ AT group - More significant improvement in ODI compared to the control group but lesser than RT.	Scale: VAS (0-10 cm) At 8 weeks: RT: −27.8% (−1.5) AT: −5.9% (−4.9) At 16 weeks: RT: −38.9% (−2.1) AT: −5.9% (−0.3) CG: −2% (−0.1)	Scale: ODI (0-100) At 8 weeks: RT: −30.2% (−12.2) AT: −4.3% (−1.7) At 16 weeks: RT: −40.1% (−16.2) AT: −9.8% (−3.9) CG: −0.2% (−0.1)	▪ Small sample size.
Chatzitheodorou et al. 57 20 patients, Aged: 25-65 years	• EG: High-intensity aerobic exercise (running on a treadmill at 60%-85% of HRR 30-50 mins session, 3 sessions per week). • CG: Received passive modalities including short-wave diathermy, ultrasound, laser, and electrotherapy without any PA. (45 min session). • Duration: 12 weeks.	• Pain intensity (MPQ) • Disability (RMDQ) • Measurements were done at baseline and after the intervention.	✓ Significant improvements in pain and disability were observed in the experimental group.	Scale: MPQ (0-78) After intervention (12 weeks): EG: −40.1% (−21.6) CG: −0.6% (−0.3)	Scale: RMDQ (0-24) After intervention (12 weeks): EG: −30.4% (−4.2) CG: −0.7% (−0.1)	▪ Small sample size. ▪ No long-term follow-up.