OBJECTIVE: To determine the effectiveness of multidisciplinary interventions including exercise in improving health outcomes for patients with non-specific chronic low back pain (NSCLBP) across different regions.
METHODS: The search for studies was not restricted to a specific time period but was conducted based on the availability of existing literature within the selected databases. A comprehensive literature search was conducted in four databases: EBSCOhost (from 1995), PubMed (from 1996), Web of Science (from 1964), and Scopus (from 2004), up to November 3, 2021. After applying exclusion criteria, 31 studies published between 1998 and 2021 were selected for final inclusion. The methodological approach included both qualitative and quantitative analyses, ensuring a comprehensive evaluation of the available evidence.
STUDY SELECTION CRITERIA: Multidisciplinary interventions including exercise aimed at relieving symptoms of NSCLBP were included. Outcomes analyzed were disability, pain, fear avoidance, quality of life, perceived change, depression, anxiety and stress. The Comprehensive Meta-Analysis software was used for statistical analyses.
RESULTS: Thirty-one studies were included in the qualitative analysis and 29 in the meta-analysis. The qualitative analysis showed improvements in favor of the intervention group (IG) in pain, fear avoidance, quality of life and perceived change. The meta-analysis reported significant pooled effect size (ES) in favor of the IGs in disability, pain, fear avoidance, quality of life, and perceived change among patients with NSCLBP.
CONCLUSION: Multidisciplinary approaches including exercise appear to be effective in reducing disability, pain, fear avoidance, quality of life and perceived change, but not depression, anxiety or stress in patients with NSCLBP. The findings should be interpreted cautiously in light of substantial heterogeneity and the limited quality of the available evidence.
| Discipline Area | Score |
|---|---|
| Rehab Clinician (OT/PT) |  |
| Physician | |
Rehab Clinician (OT/PT) rater
These results are as expected. As the authors note, comparisons were difficult due to the heterogeneity of the studies. Poor-quality studies were reviewed with high risk of bias in more than 80% of the studies, which is going to limit the efficacy of the results of the SR/MA.
Rehab Clinician (OT/PT) rater
Since exercise is not considered to be a multidisciplinary intervention, the title could clearer by indicating that they are looking at multidiscipinary interventions that INCLUDE exercise.
Rehab Clinician (OT/PT) rater
The data included are up to only 2021 despite being published in 2025. Analyses do not appear to be adjusted for risk of bias despite 40% of studies being at high risk of bias.
Rehab Clinician (OT/PT) rater
As few would appear to potentially accept a diagnosis of 'non-specific' head, chest, or abdominal pain (naming these as exemplars), it remains persistently challenging to accept a limiting diagnosis of "non-specific chronic low back pain." Fortunately, these authors appear to realise this. "The findings should be interpreted cautiously in light of substantial heterogeneity and the limited quality of the available evidence."
Ms. Heather Taylor (8/24/2025 9:50 AM)
This meta-analysis shows that multidisciplinary approaches (mostly varied exercise and education programs) seem to be more effective than controls in reducing pain, disability, and fear of pain in those with nonspecific chronic LBP. The results are limited in part due to the heterogeneity of the intervention groups throughout many studies. Minimal changes in mental health aspects were noted, which is not surprising because intervention groups did not directly attempt to address this. Details about specific exercises (including frequency, intensity, doses etc) and educational materials provided would aid in more repeatability in RCTs.
, McMaster University