| Study characteristics |
| Methods |
Study design: RCT
Setting: Canada, healthcare
Exercise groups: 3
Comparison groups: 0 |
| Participants |
Number of participants: 229 (E1 = 80, E2 = 69, E3 = 80)
Chronic LBP duration: Not specified (moderate)
Neurological/radicular symptoms: Some participants
Mean age (years): 42
Sex (female): 47% |
| Interventions |
Exercise Group 1 (E1): Matched direction: unidirectional end‐range lumbar exercises that matched their directional preference identified during assessment, recommendation to exercise every 2 hours, home exercises and compliance log; type = Mckenzie; duration = 2 weeks; dose = low; design = partially individualised; delivery = not specified; additional intervention = advice/education
Exercise Group 2 (E2): Opposite direction: unidirectional end‐range lumbar exercises in opposite direction from their directional preference identified during assessment, recommendation to exercise every 2 hours, home exercises and compliance log; type = strengthening; duration = 2 weeks; dose = low; design = partially individualised; delivery = not specified; additional intervention = advice/education & psychological therapy
Exercise Group 3 (E3): Multidirectional, midrange lumbar exercises, and stretches for the hip and thigh muscles, recommendation to exercise every 2 hours, home exercises and compliance log; type = mixed; duration = 2 weeks; dose = low; design = standardised; delivery = not specified; additional intervention = advice/education & psychological therapy |
| Outcomes |
Core outcomes reported: Pain (Visual Analogue Scale); function (Roland‐Morris Disability Questionnaire); work (ability to return to work and leisure activities); Global Perceived Health or Recovery (Global Perceived Health or Recovery (response to treatment))
Follow‐up time periods available for syntheses: 2 weeks (short) |
| Notes |
Conflicts of interest: None to declare
Funding source: Foundation funds (source not indicated)
Other: Information modified for author contact |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Low risk |
After giving informed consent, each member of these three directional preference subsets was randomised to one of three treatments. |
| Allocation concealment (selection bias) |
Low risk |
After giving informed consent, each member of these three directional preference subsets was randomised to one of three treatments. |
| Blinding of participants and personnel (performance bias)
All outcomes |
Low risk |
Same treatment but matched for directional preference |
| Blinding of care provider (performance bias) |
High risk |
Not described |
| Blinding of outcome assessment (detection bias)
All outcomes |
Low risk |
Outcome measures were administered at baseline and two weeks by nonmedical reception staff blinded to the study design. |
| Incomplete outcome data (attrition bias)
All outcomes |
High risk |
Twenty‐nine subjects (12.6%) failed to return for treatment appointments and did not provide data at two weeks. |
| Participants analysed in group allocated (attrition bias) |
Low risk |
Subjects unable/unwilling to continue for the full two‐week protocol were included in the analysis (intention‐to‐treat). |
| Selective reporting (reporting bias) |
Low risk |
Support for judgement was not available. |
| Groups similar at baseline (selection bias) |
Low risk |
Baseline characteristics of the 312 recruited subjects are listed in Table 3. |
| Co‐interventions avoided or similar (performance bias) |
Low risk |
Author contact: two‐week intervention where patients asked not to seek other care |
| Compliance acceptable in all groups (performance bias) |
Low risk |
Sixty‐eight per cent of our 201 subjects returned their compliance questionnaires with overall good compliance rating (3‐4 sets/day). |
| Timing of outcome assessment similar in all groups (detection bias) |
Low risk |
Support for judgement was not available. |
