Aerobic vs. resistance exercise for chronic non-specific low back pain: A systematic review and meta-analysis

J Back Musculoskelet Rehabil. 2018;31(5):889-899. doi: 10.3233/BMR-170920.


Background/objective: This meta-analysis compared progressive aerobic training (PAT) to progressive resistance training (PRT) for pain, disability and quality of life (QoL) in people with chronic non-specific low back pain (CNSLBP).

Methods: Five electronic databases were systematically searched up to 1 March 2016. Randomised controlled trials included land-based PAT, PRT or combined PRT and PAT, versus usual care for CNSLBP. Exercise interventions were supervised a minimum of once per week and performed ⩾ 2 days/week for ⩾ 6 weeks. Outcome measurements were pain intensity, disability, and QoL. Standardised mean difference (SMD) and mean difference (MD) were calculated using Review Manager 5.3.

Results: Six studies were included, comprising 333 participants (94 PRT, 93 PAT, 146 usual care; 66% female; age = 44 ± 6 years; duration of pain = 7 ± 6 years). Exercise significantly reduced pain intensity (SMD =-0.42 [-0.80, -0.03]; p< 0.03) although neither mode proved superior. PRT significantly improved the Short Form Health Survey-Mental Component Score (SF-MCS) (MD = 5.74 [2.02, 9.47]; p= 0.002).

Conclusions: PAT and PRT decreased pain intensity in individuals with CNSLBP although neither mode was superior. Resistance exercise improved psychological wellbeing. High-quality RCTs comparing PAT, PRT, and PAT + PRT, are required.

Keywords: Aerobic exercise; chronic low back pain; disability; quality of life; resistance exercise.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Chronic Pain / therapy*
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Low Back Pain / therapy*
  • Male
  • Middle Aged
  • Quality of Life
  • Resistance Training / methods*
  • Treatment Outcome