Prevention of non-specific back pain through exercise and education: A systematic review and meta-analysis.

BACKGROUND:Clinical practice guidelines stress the importance of prevention and treatment of non-specific back pain through exercise therapy. However, it has not yet been confirmed whether the combination of exercise plus education is more effective than such interventions taken separately. OBJECTIVE:To determine if the combination of exercise plus education is more effective for the prevention of non-specific back pain than exercise or education alone. METHOD:A systematic search of studies whose sample consisted of participants without non-specific back pain (primary prevention) and participants with non-specific back pain (secondary and tertiary prevention) was conducted in the following databases in March 2023: PubMed, Scopus, Web of Science and Medline. RESULTS:A total of 16 articles were selected. Statistically significant results were found in the pain variable with SMD =-2.02 (95% CI =-2.71 to -1.33; p< 0.001), the disability variable with SMD =-1.14 (95% CI =-1.63 to -0.65; p< 0.001), and the kinesiophobia variable with SMD =-1.8 (95% CI =-2.54 to -1.05; p< 0.001). CONCLUSION:Interventions that combine exercise and education seem to have a greater preventive effect on non-specific back pain, disability and kinesiophobia than those that include exercise or education in an isolated manner.