Study characteristics |
Methods |
Study design: RCT
Setting: USA, healthcare
Exercise groups: 4
Comparison groups: 0 |
Participants |
Number of participants: 100 (E1 = 26, E2 = 25, E3 = 24, E4 = 25)
Chronic LBP duration: 63 months (long)
Neurological/radicular symptoms: Some participants
Mean age (years): 40
Sex (female): 66% |
Interventions |
Exercise Group 1 (E1): Sahrmann & Bookhour exercises (stretches, strengthening, self‐corrections) to address specific dysfunction (i.e. innominate self‐correction, unilateral prone press‐ups); type = Pilates & stretching; duration = 5 weeks; dose = low; design = individualised; delivery = individual; additional intervention = manual therapy
Exercise Group 2 (E2): Sahrmann & Bookhour exercises (stretches, strengthening, self‐corrections) to address specific dysfunction (i.e. innominate self‐correction, unilateral prone press‐ups); type = Pilates & stretching; duration = 5 weeks; dose = low; design = individualised; delivery = individual; additional intervention = placebo
Exercise Group 3 (E3): General stretches (hamstring, knee to chest, quads, and prone on elbows), aerobic exercise (walking at fast pace for 20 minutes); type = stretching & aerobic; duration = 5 weeks; dose = low; design = individualised; delivery = individual; additional intervention = manual therapy
Exercise Group 4 (E4): General stretches (hamstring, knee to chest, quads, and prone on elbows), aerobic exercise (walking at fast pace for 20 minutes); type = stretching & aerobic; duration = 5 weeks; dose = low; design = individualised; delivery = individual; additional intervention = placebo |
Outcomes |
Core outcomes reported: Pain (Visual Analogue Scale); function (Quebec Back Pain Disability Scale)
Follow‐up time periods available for syntheses: 5 weeks (short) |
Notes |
Conflicts of interest: Not reported
Funding source: National Center for Medical Rehabilitation Research (R03‐HD35893); National Institute of Child and Human Development; National Institutes of Health
Other: Information modified for author contact |
Risk of bias |
Bias |
Authors' judgement |
Support for judgement |
Random sequence generation (selection bias) |
Unclear risk |
Author contact: 100 allocated to each grp, assigned to group based on order of entry |
Allocation concealment (selection bias) |
High risk |
Not described |
Blinding of participants and personnel (performance bias)
All outcomes |
Low risk |
The treating therapist was not blind to the treatment group of the patient, but attempted to keep patients blind to their group assignment. |
Blinding of care provider (performance bias) |
High risk |
The treating therapist was not blind to the treatment group of the patient, but attempted to keep patients blind to their group assignment. |
Blinding of outcome assessment (detection bias)
All outcomes |
Low risk |
The self‐report measures were re‐administered following the last visit with the therapist by the principal investigator, who was blinded to the treatment. |
Incomplete outcome data (attrition bias)
All outcomes |
Low risk |
Out of the 100 patients recruited, 72 patients completed the study. |
Participants analysed in group allocated (attrition bias) |
High risk |
Only patients who completed treatment were used. |
Selective reporting (reporting bias) |
Low risk |
Support for judgement was not available. |
Groups similar at baseline (selection bias) |
Low risk |
Chi‐square tests and analyses of variance (ANOVA) were used to compare the groups in terms of dropouts, age, gender, compensation status, surgical history. |
Co‐interventions avoided or similar (performance bias) |
Low risk |
Patients were allowed to continue their use of pain medications, but were asked to not change their usage during the course of the study. |
Compliance acceptable in all groups (performance bias) |
High risk |
Examination of compliance with exercise revealed that six patients who completed the study were unable to reproduce one or more of their exercises. |
Timing of outcome assessment similar in all groups (detection bias) |
Low risk |
Author contact: most were measured at five weeks. |