Acta Scientific Orthopaedics (ISSN: 2581-8635)

Review Article Volume 6 Issue 6

Effectiveness of Strengthening Exercises on Function and Pain in Adults with Low Back Pain - A Systemic Review and Meta-Analysis

Venkatanaresh Kumar Meka1 and Dinesh Dharmalingam2

1Senior Physiotherapist, Concordia University, Mequon, United States
2Senior physiotherapist, Spectrum Physio, Kaggadasapura, Bangalore, Karnataka, India

*Corresponding Author: Dinesh Dharmalingam, Senior physiotherapist, Spectrum Physio, Kaggadasapura, Bangalore, Karnataka, India.

Received: April 26, 2023; Published: May 23, 2023


The aim of this systematic review is to evaluate the effectiveness of strengthening exercises on improving strength, pain, and function in adults with low back pain. Methods: We only took in to account the randomized controlled trials (RCTs) on chronic low back pain (CLBP) where experimental group was compared with alternative therapy/control group. We compared mean and standard deviation or percentage changes between two groups for post-treatment and follow-up measurements. Results: The literature search found 14 RCTs, three of which were excluded because one was a prospective cohort study and the other two studies did not clearly report the treatment. The 11 RCTs finally included into the review applied the trunk strengthening exercises in CLBP. Results indicated that trunk-strengthening exercises decreased pain, improved strength, and function. Conclusion: The main findings from this systematic review of 11 studies showed that some patients in some studies who received trunk-strengthening exercises improved in pain, function, and strength more than those who received no treatment and alternative treatment.

Keywords:chronic low back pain; Strengthening Exercises; trunk-strengthening exercises


  1. Kravitz L and Andrews R. “Fitness and low back pain” (2009).
  2. Acute low back pain. “Evidence-based management of acute musculoskeletal pain”. Australia, Australian Academic press (2003).
  3. Van Tudler MW., et al. “Spinal radiographic findings and non- specific low back pain. A systematic review of observation studies”. Spine 22 (1997): 427-434.
  4. Merskey H and Bogduk N. “Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms”. (2nd edtion). Seattle: IASP Press (1994).
  5. Hicks GE., et al. “Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program”. Archives of Physical Medical Rehabilitation 86 (2005): 1753-1762.
  6. Wheeler HA. “Pathphysiology of chronic back pain” (2007).
  7. Borenstein DG., et al. “Low back and neck pain: comprehensive diagnosis and management (3rd). Philadelphia: W.B. Saunders Company (2004).
  8. Levangie PK and Norkin CC. “Joint structure and function: A comprehensive analysis. (4th edition). Philadelphia: F.A. Davis Company (2005).
  9. Barash PG., et al. “Clinical Anesthesia (6th). Philadelphia: Lippincott Williams and Wilkins (2009).
  10. Cox JM. “Lowback pain, mechanism, diagnosis, and treatment (6th)”. Maryland: williamis and Wilkins (1999).  
  11. Stevens VK., et al. “Electromyographic activity of trunk and hip muscles during stabilization exercises in four-point kneeling in healthy volunteers”. Europe Spine Journal 16 (2007): 711-718.
  12. Rodriquеz AA., et al. “Thеrapеutic еxеrcisе in chronic nеck and back pain”. Archivеs of Physical Mеdicinе and Rеhabilitation 73 (1992): 870-875.
  13. McCrackеn LM., et al. “Prеdiction of low back pain in patiеnts with chronic low back pain: Еffеcts of inaccuratе prеdiction and pain-rеlatеd anxiеty”. Bеhavior Rеsеarch and Thеrapy 31 (1993): 647-652.
  14. David IP. “Case book of orthopedic rehabilitation” including virtual reality. Berlin: Springer (2008).
  15. Dеyo RA. “Drug therapy for back pain: Which drugs help which patients?” Spine 21 (1996): 2840-2850.
  16. Geisser MЕ., et al. “A timе sеriеs analysis of thе rеlationship bеtwееn ambulatory ЕMG, pain, and strеss in chronic low back pain”. Biofееdback and Sеlf-Rеgulation 20 (1995): 339-355.
  17. Cost J., et al. “Classification of nonspecific low back pain Psychological involment in low back pain”. Spine 9 (1992): 1028-1037.
  18. Elnaggar IM., et al. “Effect of spinal flexion and extension exercises on low back pain and spinal mobility in chronic mechanical low-back pain patients”. Spine 26 (1990): 967-972.
  19. Akbari A., et al. “The effect of motor control exercise on lumbar local stabilizing muscles thickness”. Journal of Back and Musculoskeletal Rehabilitation 21 (2008): 105-112.
  20. Browder D., et al. “Effectiveness of an extension-oriented treatment approach in a subgroup of subjects with low back pain: A randomized clinical trial”. Physical Therapy12 (2007): 1608-1618.
  21. Goldby LJ., et al. “A randomized controlled trail investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder”. Spine10 (2006): 1083-1093.
  22. Kofotolis DN., et al. “Sequentially allocated clinical trial of rhythmic stabilization exercises and TENS in women with chronic low back pain”. Clinical Rehabiltation 22 (2008): 99-111.
  23. Koumantakis AG., et al. “Trunk muscle stabilization training plus general exercise versus general exercise only”. Physical Therapy 3 (2005): 209-225.
  24. Moffett JK., et al. “Randomized controlled trail of exercise for low back pain: clinical outcomes, cost, and preferences”. British Medical Journal 319 (1999): 279-283.
  25. Risch SV., et al. “Lumbar strengthening in chronic low back pain patients”. Spine2 (1993): 232-238.
  26. Long A., et al. “Does it matter which exercise?” Spine23 (2004): 2593-2602.
  27. Petersen T., et al. “The effect of McKenzie therapy as compared with that of intensive strengthening training for the treatment of patients with sub-acute or chronic low back pain: A randomized controlled trail”. Spine 16 (2002): 1702-1709.
  28. Schenk JR., et al. “A randomized trial comparing interventions in patients with lumbar posterior derangement”. The Journal of Manual and Manipulative Therapy2 (2009): 95-102.
  29. Fritz JM and Irrgang JJ. “A comparison of a modified Oswestry Low Back Pain Disability Questionnaire and the Quebec Back Pain Disability Scale”. Physical Therapy 81 (2001): 776-788.
  30. Hayden JA., et al. “Meta-analysis: exercise therapy for nonspecific low back pain”. American College of Physicians142 (2004): 765-775.
  31. O’Sullivan SB and Schmitz TJ. “Physical rehabilitation: assessment and treatment (4th edition)”. Philadelphia: F.A. Davis Company (2001).
  32. PEDro scale (2009).
  33. Petersen T., et al. “One year follow-up comparison of the effectiveness of McKenzie treatment and strengthening training for patients with chronic low back pain”. Spine 26 (2007):  2948-2956.
  34. Sertpoyraz F., et al. “Comparison of isokinetic exercise versus standard exercise training in patients with chronic low back pain: A randomized controlled study”. Clinical Rehabilitation 3 (2009): 238-247.


Citation: Venkatanaresh kumar Meka and Dinesh Dharmalingam. “Effectiveness of Strengthening Exercises on Function and Pain in Adults with Low Back Pain - A Systemic Review and Meta-Analysis”.Acta Scientific Orthopaedics 6.6 (2023): 63-72.


Copyright: © 2023 Venkatanaresh kumar Meka and Dinesh Dharmalingam. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate33%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US