| Study characteristics |
| Methods |
Study design: RCT
Setting: Austria, not specified
Exercise groups: 1
Comparison groups: 1 |
| Participants |
Number of participants: 30 (E1 = 15, C1 = 15)
Chronic LBP duration: 67.365 months (long)
Neurological/radicular symptoms: Not specified
Mean age (years): 28
Sex (female): Not reported |
| Interventions |
Exercise Group 1 (E1): Climbing: participants climbed 5 bouldering routes in an indoor climbing centre with instruction on proper body position and movement; type = other (rock climbing); duration = 8 weeks; dose = low; design = standardised; delivery = group; additional intervention = none
Comparison Group 1 (C1): Usual care/no treatment (control group: instructed not to change lifestyle, allowed to take paracetamol 500 mg 4 times daily if needed and not allowed to go rock climbing) |
| Outcomes |
Core outcomes reported: Pain (Visual Analogue Scale); function (Oswestry Disability Index)
Follow‐up time periods available for syntheses: 14 weeks (moderate) |
| Notes |
Conflicts of interest: None to declare
Funding source: Not reported
Other: None |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Low risk |
Computer‐generated randomisation system, provided by the Institute of Medical Statistics |
| Allocation concealment (selection bias) |
Low risk |
Randomisation system was provided by third party (Institute of Medical Statistics). |
| Blinding of participants and personnel (performance bias)
All outcomes |
Low risk |
1. Patients could not be blinded due to the nature of the interventions; 2. Unlikely that lack of participant blinding caused deviations from protocol; participants in climbing group needed instructor, and in control group were allowed to continue their routines without climbing |
| Blinding of care provider (performance bias) |
Low risk |
1. Only care providers involved were the climbing instructors, who could not be blinded due to their involvement in delivering the intervention; 2. Lack of care provider blinding was unlikely to lead to deviations from the intended intervention because the only care provider involved was the climbing instructor. |
| Blinding of outcome assessment (detection bias)
All outcomes |
High risk |
1. For the outcomes of interest (pain and disability), participants were the outcomes assessors; they could not be blinded due to the nature of the treatments; 2. Pain and functional questionnaires are subjective, and responses could be altered by awareness of intervention; 3. Outcomes in an exercise versus no treatment study likely to be altered by knowledge of intervention assignment. |
| Incomplete outcome data (attrition bias)
All outcomes |
Low risk |
1. No dropouts in this study |
| Participants analysed in group allocated (attrition bias) |
Low risk |
1. All participants were analysed according to their allocated treatment group. |
| Selective reporting (reporting bias) |
Low risk |
1. No linked protocol found: within this paper no obvious omissions of outcomes or analyses |
| Groups similar at baseline (selection bias) |
Low risk |
All relevant characteristics were measured and were similar across groups at baseline. |
| Co‐interventions avoided or similar (performance bias) |
Low risk |
Control group allowed to take paracetamol if needed, asked to note this; they were asked to not go rock climbing; all patients allowed to continue any of their routine physical activity. |
| Compliance acceptable in all groups (performance bias) |
Low risk |
Compliance appeared to have been 100% (only applicable for rock climbing group). |
| Timing of outcome assessment similar in all groups (detection bias) |
Low risk |
1. All outcomes were measured at the same time point for all participants; within each outcome, all participants were measured using the same tool; 2. Visual Analogue Scale (for pain) and Oswestry Disability Index (for disability) are well‐validated tools in the context of low back pain. |
| Other bias |
Low risk |
Appeared free from other sources of bias |
