Optimal modes of mind-body exercise for treating chronic non-specific low back pain: Systematic review and network meta-analysis

Author: Jian Shi1,2, Zheng-Yu Hu1,2, Yu-Rong Wen3, Ya-Fei Wang2, Yang-Yang Lin2, Hao-Zhi Zhao1,2, You-Tian Lin2,4, Yu-Ling Wang2
Affiliation: <sup>1</sup> College of Kinesiology, Shenyang Sport University, Shenyang, China. <sup>2</sup> Rehabilitation Medicine Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. <sup>3</sup> Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China. <sup>4</sup> Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China.
Conference/Journal: Front Neurosci
Date published: 2022 Nov 17
Other: Volume ID: 16 , Pages: 1046518 , Special Notes: doi: 10.3389/fnins.2022.1046518. , Word Count: 243

There were limited studies that directly compare the outcomes of various mind-body exercise (MBE) therapies on chronic non-specific low back pain (CNLBP).

To compare the efficacy of the four most popular MBE modes [Pilates, Yoga, Tai Chi (TC), and Qigong] in clinically CNLBP patients, we conducted a systematic review and network meta-analysis (NMA).

We searched databases for eligible randomized controlled trials (RCTs) (from origin to July 2022). RCTs were eligible if they included adults with CNLBP, and implemented one or more MBE intervention arms using Pilates, yoga, TC, and qigong. In addition, pain intensity and physical function were evaluated using validated questionnaires.

NMA was carried out on 36 eligible RCTs involving 3,050 participants. The effect of exercise therapy on pain was in the following rankings: Pilates [Surface under cumulative ranking (SUCRA) = 86.6%], TC (SUCRA = 77.2%), yoga (SUCRA = 67.6%), and qigong (SUCRA = 64.6%). The effect of exercise therapy on function: Pilates (SUCRA = 98.4%), qigong (SUCRA = 61.6%,), TC (SUCRA = 59.5%) and yoga (SUCRA = 59.0%).

Our NMA shows that Pilates might be the best MBE therapy for CNLBP in pain intensity and physical function. TC is second only to Pilates in improving pain in patients with CNLBP and has the value of promotion. In the future, we need more high-quality, long-term follow-up RCTs to confirm our findings.

Systematic review registration:
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=306905, identifier: CRD42022306905.

Keywords: Pilates; chronic low back pain; mind-body exercise; network meta-analysis; qigong; tai chi; yoga.

PMID: 36466167 PMCID: PMC9713308 DOI: 10.3389/fnins.2022.1046518