Quality of systematic reviews on specific spinal stabilization exercise for chronic low back pain

J Orthop Sports Phys Ther. 2013 Apr;43(4):242-50. doi: 10.2519/jospt.2013.4346. Epub 2013 Jan 14.


Study design: Systematic literature review.

Objective: To evaluate the quality of systematic reviews (SRs) on specific stabilization exercises for chronic low back pain (LBP).

Background: Multiple SRs regarding the effectiveness of lumbar stabilization exercises for people with chronic LBP have been published. As more SRs are published, the more it is recognized that, like other forms of research, methodological quality affects the validity of, and conclusions drawn from, the data.

Methods: A search of MEDLINE, CINAHL, and Embase was completed. Additionally, the PEDro database was screened and hand searching was completed. Included SRs had to contain randomized controlled trials examining a specific stabilization exercise program for the treatment of chronic LBP. Additionally, the assessed outcome measures had to include pain and/or disability measures. Literature reviews and clinical practice guidelines were excluded. Three reviewers independently assessed each SR for methodological quality.

Results: The search produced 665 SRs for review, of which 8 fulfilled the inclusion criteria. Consensus quality assessment scores ranged from 13/26 to 26/26, with an average of 20.7 points. Percent agreement and kappa values for individual criteria scores ranged from 50% to 92% and 0.25 to 0.85, respectively. Agreement was moderate to substantial across individual items, except for criterion 1. The intraclass correlation coefficient for overall score was 0.98 (95% confidence interval: 0.96, 0.99).

Conclusion: This review of SRs identified several high-quality reviews that indicated some benefit of specific stabilization exercise programs for patients with nonspecific chronic LBP.

Level of evidence: Therapy, level 1a.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Chronic Disease
  • Clinical Trials as Topic / methods*
  • Clinical Trials as Topic / standards*
  • Exercise Therapy*
  • Humans
  • Low Back Pain / therapy*