Cheng Mei, Tian Yu, Ye Qi, Li Jun, Xie Lin, Ding Fan
Department of Spinal Surgery, Wuhan Pu Ren Hospital, Wuhan, 430081, China.
Sports Medicine College, Wuhan Sports University, Wuhan, 430079, China.
BMC Musculoskelet Disord. 2025 May 1;26(1):433. doi: 10.1186/s12891-025-08658-0.
To validate the effectiveness of six exercise therapies in treating low back pain using Meta-analysis methods, and to propose optimal exercise duration, frequency, and cycle.
Databases such as PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, VIP Data, and SinoMed were searched. The RevMan 5.4 tool was utilized to conduct subgroup analyses on eight moderating variables, including types of exercise, duration, frequency, cycle, sample size, study quality, outcome indicator, and comparisons of different intervention methods with the control group from 42 included studies. Random effects models were employed to test for overall effects, heterogeneity, and bias.
The overall effect size for six exercise therapies for low back pain was significant (SMD= -1.21, P < 0.00001). Subgroup analyses showed yoga had the largest effect (SMD= -1.97, P = 0.0001). Exercise duration ≤ 30 min (SMD= -1.31, P < 0.0001), frequencies > 4 times/week (SMD= -1.56, P < 0.00001), and cycles ≤ 4 weeks (SMD= -1.61, P < 0.00001) were most effective. Sample sizes of 30~60 cases (SMD= -1.36, P < 0.00001) and studies with moderate bias risk (SMD= -1.37, P < 0.00001) also showed large effects. The Oswestry Disability Index scores demonstrated the most significant effect size (SMD= -3.35, P < 0.00001). The effect size of the physical factors in the control group was the largest (SMD= -1.85, P < 0.00001).
All six exercise therapies effectively alleviated low back pain, with yoga showing the best results. The optimal exercise intervention protocol involved exercise duration not exceeding 30 min per session, frequency of more than 4 times per week, and cycle not exceeding 4 weeks. Additionally, exercise interventions exhibited the most significant improvements in Oswestry Disability Index scores for low back pain.
采用Meta分析方法验证六种运动疗法治疗腰痛的有效性，并提出最佳运动时长、频率和周期。
检索PubMed、EMBASE、Cochrane图书馆、中国知网、维普数据和中国生物医学文献数据库等数据库。利用RevMan 5.4工具对纳入的42项研究中的八个调节变量进行亚组分析，包括运动类型、时长、频率、周期、样本量、研究质量、结局指标以及不同干预方法与对照组的比较。采用随机效应模型检验总体效应、异质性和偏倚。
六种运动疗法治疗腰痛的总体效应量显著（标准化均数差[SMD]= -1.21，P < 0.00001）。亚组分析显示瑜伽的效果最大（SMD= -1.97，P = 0.0001）。运动时长≤30分钟（SMD= -1.31，P < 0.0001）、频率>4次/周（SMD= -1.56，P < 0.00001）和周期≤4周（SMD= -1.61，P < 0.00001）最为有效。样本量为30~60例（SMD= -1.36，P < 0.00001）以及偏倚风险为中度的研究（SMD= -1.37，P < 0.00001）也显示出较大效应。Oswestry功能障碍指数评分的效应量最为显著（SMD= -3.35，P < 0.00001）。对照组中物理因素的效应量最大（SMD= -1.85，P < 0.00001）。
所有六种运动疗法均能有效缓解腰痛，其中瑜伽效果最佳。最佳运动干预方案为每次运动时长不超过30分钟、每周频率超过4次、周期不超过4周。此外，运动干预对腰痛的Oswestry功能障碍指数评分改善最为显著。
