Effectiveness of walking versus mind-body therapies in chronic low back pain: A systematic review and meta-analysis of recent randomized controlled trials.
Study Goal
The researchers aimed to compare the effectiveness of walking and mind-body therapies (MBTs) in relieving pain and improving function in patients with chronic low back pain (CLBP).
Results Summary
Walking was as effective as control interventions in the short term and slightly superior in the intermediate term for pain relief and reducing activity limitation. Yoga (a type of MBT) showed greater short-term effectiveness but lost superiority at the 6-month follow-up.
Population
Adults with chronic low back pain (CLBP).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Walking | no change | pain | adults with CLBP | - | was as effective as control interventions | #1 |
Walking | no change | activity limitation | adults with CLBP | - | was as effective as control interventions | #2 |
Walking | decrease | pain | adults with CLBP | SMD = -0.34; 95% CI, -0.65 to -0.03; P = .03 | slightly superior | #3 |
Walking | decrease | activity limitation | adults with CLBP | SMD = -0.30; 95% CI, -0.50 to -0.10; P = .003 | slightly superior | #4 |
yoga | decrease | pain | adults with CLBP | SMD = -1.47; 95% CI, -2.26 to -0.68; P = .0003 | more effective than control interventions | #5 |
yoga | decrease | activity limitation | adults with CLBP | SMD = -1.17; 95% CI, -1.80 to -0.55; P = .0002 | more effective than control interventions | #6 |
yoga | no change | pain | adults with CLBP | - | no longer superior to the control interventions | #7 |
MBTs, especially yoga | decrease | pain | patients with CLBP | - | more effective in the short term | #8 |
MBTs, especially yoga | decrease | activity limitation | patients with CLBP | - | more effective in the short term | #9 |
walking | decrease | pain | patients with CLBP | - | more effective in the intermediate term | #10 |
walking | decrease | activity limitation | patients with CLBP | - | more effective in the intermediate term | #11 |
PURPOSE: Walking and mind-body therapies (MBTs) are commonly recommended to relieve pain and improve function in patients with chronic low back pain (CLBP). The purpose of this study was to compare the effectiveness of walking and MBTs in CLBP. METHODS: We included randomized controlled trials (RCTs) comparing walking or MBTs to any other intervention or control in adults with CLBP. Studies were identified through PubMed, Cochrane Library, PsycINFO, Scopus, and ScienceDirect databases. The research was limited to studies published in English and French between January 2008 and December 2018. Two reviewers independently selected the studies, extracted data, and assessed studies quality using the Physiotherapy Evidence Database (PEDro) scale. Statistical analyses were performed under a random-effects model. We analyzed pain and activity limitation, with the calculation of standardized mean differences and 95% confidence intervals for the different treatment effects. RESULTS: Thirty one randomized controlled trials involving 3193 participants were analyzed. Walking was as effective as control interventions in the short-term and slightly superior in the intermediate term with respect to pain (Standardized mean differences (SMD) = -0.34; 95% CI, -0.65 to -0.03; P = .03) and activity limitation (SMD = -0.30; 95% CI, -0.50 to -0.10; P = .003). In contrast, yoga was more effective than control interventions in the short term in terms of pain (SMD = -1.47; 95% CI, -2.26 to -0.68; P = .0003) and activity limitation (SMD = -1.17; 95% CI, -1.80 to -0.55; P = .0002). Yoga was no longer superior to the control interventions for pain at the 6-month follow-up. CONCLUSION: MBTs, especially yoga, seem to be more effective in the short term, and walking seems to be more effective in the intermediate term, for the relief of pain and activity limitation in patients with CLBP. A combination of walking and MBTs fits the biopsychosocial model and might be valuable therapy for CLBP throughout follow-up due to combined effects.