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dc.contributor.authorHayden, Jill A.
dc.contributor.authorWilson, Maria N.
dc.contributor.authorStewart, Samuel
dc.contributor.authorCartwright, Jennifer L.
dc.contributor.authorSmith, Andrea O.
dc.contributor.authorRiley, Richard D.
dc.contributor.authorvan Tulder, Maurits
dc.contributor.authorBendix, Tom
dc.contributor.authorCecchi, Francesca
dc.contributor.authorCosta, Leonardo O.P.
dc.contributor.authorDufour, Ninna
dc.contributor.authorFerreira, Manuela L.
dc.contributor.authorFoster, Nadine E.
dc.contributor.authorGudavalli, Maruti R.
dc.contributor.authorHartvigsen, Jan
dc.contributor.authorHelmhout, Pieter
dc.contributor.authorKool, Jan
dc.contributor.authorKoumantakis, George A.
dc.contributor.authorKovacs, Francisco M.
dc.contributor.authorKuukkanen, Tiina
dc.contributor.authorLong, Audrey
dc.contributor.authorMacedo, Luciana G.
dc.contributor.authorMachado, Luciana A.C.
dc.contributor.authorMaher, Chris G.
dc.contributor.authorMehling, Wolf
dc.contributor.authorMorone, Giovanni
dc.contributor.authorPeterson, Tom
dc.contributor.authorRasmussen-Barr, Eva
dc.contributor.authorRyan, Cormac G.
dc.contributor.authorSjögren, Tuulikki
dc.contributor.authorSmeets, Rob
dc.contributor.authorStaal, J. Bart
dc.contributor.authorUnsgaard-Tøndel, Monica
dc.contributor.authorWajswelner, Henry
dc.contributor.authorYeung, Ella W.
dc.date.accessioned2020-03-05T08:31:28Z
dc.date.available2020-03-05T08:31:28Z
dc.date.created2020-01-22T18:48:01Z
dc.date.issued2019
dc.identifier.citationBritish Journal of Sports Medicine. 2019, 0 1-16.nb_NO
dc.identifier.issn0306-3674
dc.identifier.urihttp://hdl.handle.net/11250/2645391
dc.description.abstractBackground Low back pain is one of the leading causes of disability worldwide. Exercise therapy is widely recommended to treat persistent non-specific low back pain. While evidence suggests exercise is, on average, moderately effective, there remains uncertainty about which individuals might benefit the most from exercise. Methods In parallel with a Cochrane review update, we requested individual participant data (IPD) from high-quality randomised clinical trials of adults with our two primary outcomes of interest, pain and functional limitations, and calculated global recovery. We compiled a master data set including baseline participant characteristics, exercise and comparison characteristics, and outcomes at short-term, moderate-term and long-term follow-up. We conducted descriptive analyses and one-stage IPD meta-analysis using multilevel mixed-effects regression of the overall treatment effect and prespecified potential treatment effect modifiers. Results We received IPD for 27 trials (3514 participants). For studies included in this analysis, compared with no treatment/usual care, exercise therapy on average reduced pain (mean effect/100 (95% CI) −10.7 (−14.1 to –7.4)), a result compatible with a clinically important 20% smallest worthwhile effect. Exercise therapy reduced functional limitations with a clinically important 23% improvement (mean effect/100 (95% CI) −10.2 (−13.2 to –7.3)) at short-term follow-up. Not having heavy physical demands at work and medication use for low back pain were potential treatment effect modifiers—these were associated with superior exercise outcomes relative to non-exercise comparisons. Lower body mass index was also associated with better outcomes in exercise compared with no treatment/usual care. This study was limited by inconsistent availability and measurement of participant characteristics. Conclusions This study provides potentially useful information to help treat patients and design future studies of exercise interventions that are better matched to specific subgroups.nb_NO
dc.language.isoengnb_NO
dc.publisherBMJ Publishing Groupnb_NO
dc.titleExercise treatment effect modifiers in persistent low back pain: An individual participant data meta-analysis of 3514 participants from 27 randomised controlled trialsnb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.description.versionpublishedVersionnb_NO
dc.source.pagenumber1-16nb_NO
dc.source.volume0nb_NO
dc.source.journalBritish Journal of Sports Medicinenb_NO
dc.identifier.doi10.1136/bjsports-2019-101205
dc.identifier.cristin1780441
dc.description.localcode© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.nb_NO
cristin.unitcode194,65,30,0
cristin.unitcode194,65,20,0
cristin.unitnameInstitutt for nevromedisin og bevegelsesvitenskap
cristin.unitnameInstitutt for samfunnsmedisin og sykepleie
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode2


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