{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T04:01:56Z","timestamp":1792814516750,"version":"4.5.0"},"reference-count":72,"publisher":"BMJ","issue":"21","funder":[{"DOI":"10.13039\/501100000194","name":"Nova Scotia Health Research Foundation","doi-asserted-by":"publisher","award":["PSO2011-7506"],"award-info":[{"award-number":["PSO2011-7506"]}],"id":[{"id":"10.13039\/501100000194","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2019,11,13]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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) \u221210.7 (\u221214.1 to \u20137.4)), 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) \u221210.2 (\u221213.2 to \u20137.3)) at short-term follow-up. Not having heavy physical demands at work and medication use for low back pain were potential treatment effect modifiers\u2014these 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides potentially useful information to help treat patients and design future studies of exercise interventions that are better matched to specific subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Protocol publication<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/doi.org\/10.1186\/2046-4053-1-64\">https:\/\/doi.org\/10.1186\/2046-4053-1-64<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2019-101205","type":"journal-article","created":{"date-parts":[[2019,11,28]],"date-time":"2019-11-28T17:19:24Z","timestamp":1574961564000},"page":"1277-1278","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":117,"title":["Exercise treatment effect modifiers in persistent low back pain: an individual participant data meta-analysis of 3514 participants from 27 randomised controlled trials"],"prefix":"10.1136","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7026-144X","authenticated-orcid":false,"given":"Jill A","family":"Hayden","sequence":"first","affiliation":[{"name":"Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria N","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L","family":"Cartwright","sequence":"additional","affiliation":[{"name":"Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea O","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard D","family":"Riley","sequence":"additional","affiliation":[{"name":"Research Institute for Primary Care and Health Sciences, Keele University, Keele, 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