| Study characteristics |
| Methods |
Study design: RCT
Setting: New Zealand, mixed
Exercise groups: 4
Comparison groups: 0 |
| Participants |
Number of participants: 50 (E1 = 12, E2 = 12, E3 = 13, E4 = 13)
Chronic LBP duration: 3.85 years (long)
Neurological/radicular symptoms: Some participants
Mean age (years): 37
Sex (female): 49% |
| Interventions |
Exercise Group 1 (E1): Swiss ball exercises (after 4‐week non‐manipulation treatment) 3 phases: 0‐4 weeks (isometric), 4‐8 weeks (controlled concentric/eccentric), 8‐12 weeks (dynamic); type = core strengthening; duration = 16 weeks; dose = low; design = partially individualised; delivery = individual; additional intervention = advice/education
Exercise Group 2 (E2): Swiss ball exercises (after 4‐week manipulation treatment) 3 phases: 0‐4 weeks (isometric), 4‐8 weeks (controlled concentric/eccentric), 8‐12 weeks (dynamic); type = core strengthening; duration = 12 weeks; dose = low; design = partially individualised; delivery = individual; additional intervention = manual therapy
Exercise Group 3 (E3): Home exercises (after 4‐week non‐manipulation treatment): demonstration and info sheet providing pictures of exercises (lunges, push up, bridge pose, plank); type = core strengthening & core strengthening; duration = 16 weeks; dose = low; design = partially individualised; delivery = independent; additional intervention = advice/education
Exercise Group 4 (E4): Home exercises (after 4‐week manipulation treatment): demonstration and info sheet providing pictures of exercises (lunges, push up, bridge pose, plank); type = core strengthening & core strengthening; duration = 12 weeks; dose = low; design = partially individualised; delivery = independent; additional intervention = advice/education & manual therapy |
| Outcomes |
Core outcomes reported: Pain (Visual Analogue Scale); function (Oswestry Disability Index); HRQoL (12‐Item Short Form Survey)
Follow‐up time periods available for syntheses: 12 weeks (short); 40 weeks (moderate) |
| Notes |
Conflicts of interest: None to declare
Funding source: No funding received
Other: Information modified for author contact |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Unclear risk |
These individuals who had not already undergone self‐selected treatment were randomly assigned to either manipulation or nonmanipulative treatment. |
| Allocation concealment (selection bias) |
High risk |
Not described |
| Blinding of participants and personnel (performance bias)
All outcomes |
Unclear risk |
The provision of exercise advice to this group ensured that the blinding to the Swiss ball exercise group was successfully achieved. |
| Blinding of care provider (performance bias) |
High risk |
Not described |
| Blinding of outcome assessment (detection bias)
All outcomes |
High risk |
Not described |
| Incomplete outcome data (attrition bias)
All outcomes |
Low risk |
Six people dropped out; three through non‐attendance, two gave no reasons, one sought other treatment. |
| Participants analysed in group allocated (attrition bias) |
High risk |
Fifty subjects analysed only |
| Selective reporting (reporting bias) |
Low risk |
Support for judgement was not available. |
| Groups similar at baseline (selection bias) |
Low risk |
See Table 1 ‐ all non significant |
| Co‐interventions avoided or similar (performance bias) |
High risk |
There was no restriction placed on what forms of exercise were prescribed by the treating specialists who assisted this study. |
| Compliance acceptable in all groups (performance bias) |
Unclear risk |
Attendance at supervised training and programme: compliance within the Swiss ball training groups was comparable. |
| Timing of outcome assessment similar in all groups (detection bias) |
Low risk |
Support for judgement was not available. |
