| Study characteristics |
| Methods |
Study design: RCT
Setting: United Kingdom, healthcare
Exercise groups: 1
Comparison groups: 2 |
| Participants |
Number of participants: 239 (E1 = 80, C1 = 80, C2 = 79)
Chronic LBP duration: Not specified (not specified)
Neurological/radicular symptoms: No participants
Mean age (years): 43
Sex (female): 57% |
| Interventions |
Exercise Group 1 (E1): Circuit training, basic postural setting with transverse abdominis and multifidus muscles, home stretching exercises; type = core strengthening & stretching; duration = 12 weeks; dose = low; design = standardised; delivery = group; additional intervention = advice/education
Comparison Group 1 (C1): Other conservative treatment (physical therapy)
Comparison Group 2 (C2): Other conservative treatment (manual therapy) |
| Outcomes |
Core outcomes reported: Pain (Visual Analogue Scale); function (Oswestry Disability Index); work (questions); HRQoL (EuroQol 5D)
Follow‐up time periods available for syntheses: 6 weeks (short); 52 weeks (long) |
| Notes |
Conflicts of interest: None to declare
Funding source: St. Albans and Hemel Hempstead National Health Services Trust Research and Development Consortium
Other: None |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Low risk |
Patients were assigned at random to one of the three therapy regimens by an independent administrator, using block randomisation methods. |
| Allocation concealment (selection bias) |
Low risk |
Where feasible, individuals involved in the conduct and analysis of the study were blind to either group membership and/or baseline assessments. |
| Blinding of participants and personnel (performance bias)
All outcomes |
High risk |
Assumed not possible |
| Blinding of care provider (performance bias) |
High risk |
Assumed not possible |
| Blinding of outcome assessment (detection bias)
All outcomes |
Low risk |
All follow‐up assessments were undertaken by an independent assessor who was blind to baseline measurements and group allocation. |
| Incomplete outcome data (attrition bias)
All outcomes |
High risk |
Ninety‐eight of the 239 (41%) eligible participants provided six‐week follow‐up data. |
| Participants analysed in group allocated (attrition bias) |
High risk |
Given the severe reduction in the number of participants with follow‐up measurements at six weeks, the results of statistical analysis have been presented as key summary statistics with 95% confidence limits. |
| Selective reporting (reporting bias) |
Low risk |
Support for judgement was not available. |
| Groups similar at baseline (selection bias) |
Low risk |
Patient randomisation yielded three groups that were highly comparable in terms of basic demography. |
| Co‐interventions avoided or similar (performance bias) |
Unclear risk |
Not described |
| Compliance acceptable in all groups (performance bias) |
High risk |
Group therapy had the worst attendance, with only 40% of patients completing all therapy sessions, compared with 74% and 80% within other treatments. |
| Timing of outcome assessment similar in all groups (detection bias) |
Low risk |
Support for judgement was not available. |
