Impact of Exercise Therapy on Outcomes in Patients with Low Back Pain: An Umbrella Review of Systematic Reviews

Dmitriy Viderman, Sultan Kalikanov, Zhuldyz Myrkhiyeva, Shakhrizat Alisherov, Mukhit Dossov, Serik Seitenov, Yerkin G. Abdildin

2025

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.3390/jcm14175942
Data confidence 70 medium
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Abstract

Objective: This umbrella review aims to analyze the effectiveness of exercise therapy for low back pain through an analysis of systematic reviews that evaluate pain reduction, quality of life improvement, and functional outcomes. Methods: This review adhered to PRISMA guidelines and systematic review of review recommendations by searching across PubMed, Scopus, and the Cochrane Library. This study searched for systematic reviews alongside meta-analyses that evaluated exercise interventions in treating low back pain (LBP). This study included reviews that examined exercise therapy for LBP patients and presented data regarding their pain intensity, disability, and quality-of-life outcomes. Data extraction and quality assessment were performed independently by several reviewers. The methodological quality of the included systematic reviews was assessed using the AMSTAR 2 tool. Results: This research yielded 88 systematic reviews from 997 evaluated records. Reduction of pain emerged as the primary measured outcome in systematic reviews (81.8%, n = 72), and these studies showed significant improvement rates of 83.0%. The proportion of studies that concluded no change was 9.1%. The most frequently studied exercises were strengthening, aerobic, and mind–body exercises. The reviews reported quality of life improvements in 27.3% (n = 24), but most reviews (68.2%) did not assess this outcome. No studies indicated worsening outcomes. Exercise interventions demonstrated various forms that effectively contribute to LBP management, according to the study results. Conclusions: This umbrella review of 88 systematic reviews highlights that exercise therapy is a safe, effective, and commonly used strategy for managing low back pain. However, key limitations include the low methodological quality of several included reviews, risk of bias, imprecision, limited reporting of adverse effects, and confounding from multicomponent interventions. While there is limited certainty that any one type of exercise is more effective than others, individualized approaches and patient adherence appear to be critical factors in optimizing outcomes.