Reproducibility of resistance exercise therapy interventions in trials for chronic low back pain is challenging: A systematic review

Kevin L MacPherson; Lindsey Hughey; Daniel I Rhon; Jodi L Young

doi:10.1002/msc.1685

Reproducibility of resistance exercise therapy interventions in trials for chronic low back pain is challenging: A systematic review

Musculoskeletal Care. 2023 Mar;21(1):202-211. doi: 10.1002/msc.1685. Epub 2022 Aug 25.

Authors

Kevin L MacPherson^{1

2}, Lindsey Hughey^{2

3}, Daniel I Rhon^{2

4}, Jodi L Young²

Affiliations

¹ Department of Physical Therapy, University of Florida, Gainesville, Florida, USA.
² Doctor of Science in Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA.
³ South College DPT, Knoxville, Tennessee, USA.
⁴ Department of Rehabilitation Medicine, Uniformed Services University of Health Science, Bethesda, Maryland, USA.

PMID: 36004824
DOI: 10.1002/msc.1685

Abstract

Objective: Determine reproducibility of resistance exercise regimens in trials for CLBP and determine if recently available checklists are effective.

Methods: Four databases (Medline, PubMed, Cochrane and CINAHL) were searched for keywords related to back pain and resistance exercise. Reproducibility was assessed using two checklists, the 12-item Template for Intervention Description and Replication (TIDieR) and the 19-item Consensus on Exercise Reporting Template (CERT). The proportion reporting was analysed, with additional comparison of trials pre- and post-availability of each checklist. A generalised linear regression was conducted with checklist items as the dependent variable and year of publication as the independent (PROSPERO ID = #CRD42020186036).

Results: Overall, details that facilitate reproducibility were under-reported. No trials reported all checklist items, while only 18 trials (35.5%) and 5 trials (9.8%) reported 75%+ of checklist items for the TIDieR and CERT, respectively. A median of 8 (IQR 2) of 12 TIDieR criteria were reported and a median of 9 (IQR 7) of 19 criteria were reported for the CERT. There was no difference pre/post checklist publication (TIDieR median before = 8 (IQR 2), after = 8 (IQR 2.25); CERT mean before = 9 (IQR 5.25), after = 9 (IQR 7)). Regression failed to support improved reporting over time. The majority of studies (86.3%) were scored as having an elevated risk of bias.

Conclusions: Reproducibility of resistance exercise in CLBP trials appears questionable due to low levels of reporting. The publication reporting checklists have not resulted in improvement. Real-world reproducibility is questionable. There is a need to improve reporting to maximise reproducibility.

Impact statement: The present results reveal a demand in improved reporting to ensure both enhanced clinical translation in the real-world and replicability to enhance knowledge of best-practice for resistance exercise in the CLBP population.

Keywords: chronic low back pain; exercise reporting; resistance exercise.

Publication types

Systematic Review
Review

MeSH terms

Exercise
Exercise Therapy / methods
Humans
Low Back Pain*
Reproducibility of Results
Resistance Training*