Abstract
BackgroundTrials on sling exercise (SE), commonly performed to manage chronic low back pain (LBP), yield conflicting results. This study aimed to review the effects of SE on chronic LBP.MethodsThe randomized controlled trials comparing SE with other treatments or no treatment, published up to August 2013, were identified by electronic searches. Primary outcomes were pain, function, and return to work. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated, using a random-effects model.ResultsRisk of bias was rated as high in 9 included trials, where some important quality components such as blinding were absent and sample sizes were generally small. We found no clinically relevant differences in pain or function between SE and other forms of exercise, traditional Chinese medical therapy, or in addition to acupuncture. Based on two trials, SE was more effective than thermomagnetic therapy at reducing pain (short-term: WMD –13.90, 95% CI –22.19 to –5.62; long-term: WMD –26.20, 95% CI –31.32 to –21.08) and improving function (short-term: WMD –10.54, 95% CI –14.32 to –6.75; long-term: WMD –25.75, 95% CI –30.79 to –20.71). In one trial we found statistically significant differences between SE and physical agents combined with drug therapy (meloxicam combined with eperisone hydrochloride) but of borderline clinical relevance for pain (short-term: WMD –15.00, 95% CI –19.64 to −10.36) and function (short-term: WMD −10.00; 95% CI −13.70 to −6.30). There was substantial heterogeneity among the two trials comparing SE and thermomagnetic therapy; both these trials and the trial comparing SE with physical agents combined with drug therapy had serious methodological limitations.InterpretationBased on limited evidence from 2 trials, SE was more effective for LBP than thermomagnetic therapy. Clinically relevant differences in effects between SE and other forms of exercise, physical agents combined with drug therapy, traditional Chinese medical therapy, or in addition to acupuncture could not be found. More high-quality randomized trials on the topic are warranted.
Highlights
Low back pain (LBP) is a very common disorder [1], with approximately 84% of adults experiencing an episode of low back pain (LBP) at some point during their lifetimes [2] and variable recurrence rates (5% to 60%) [3]
Self-reported pain and back pain specific functional status were evaluated in a randomized controlled trial [38], in which 82 patients receiving sling exercise (SE) and another 82 patients receiving physical agents combined with drug therapy were included
In this trial [38], self-reported pain was determined using numerical pain rating scale (NPRS), and back pain specific functional status was determined using modified Oswestry disability index (M-Oswestry disability index (ODI)). This trial [38] showed significant differences between SE and physical agents combined with drug therapy for either selfreported pain [–15.00 point (CI = –19.64 to –10.36)] or back pain specific functional status [–10.00 point (CI = –13.70 to –6.30)] at short-term follow-up period
Summary
Low back pain (LBP) is a very common disorder [1], with approximately 84% of adults experiencing an episode of LBP at some point during their lifetimes [2] and variable recurrence rates (5% to 60%) [3]. In the United States, back pain-related lost productive work time in workers aged between 40 and 65 years costs employers an estimated $7.40 billion per year [20]; and an estimated $50 billion is spent annually on LBP treatments [21]. In Australia, direct medical costs associated with LBP treatments are estimated at more than $1 billion per year, with additional $8 billion covering indirect expenses [22]. Chronic LBP accounts for three-quarters of the total direct and indirect costs of medical care and lost productivity associated with LBP [27]. This study aimed to review the effects of SE on chronic LBP
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
