{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:50:16Z","timestamp":1793303416086,"version":"4.5.0"},"reference-count":59,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"5","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p> OBJECTIVE: To quantify the dose-response relationship between overall and specific exercise modalities and pain, in patients with nonspecific chronic low back pain (LBP). <\/jats:p><jats:p> DESIGN: Systematic review with Bayesian network meta-analysis. <\/jats:p><jats:p> LITERATURE SEARCH: We searched the Medline, Embase, Web of Science, Cochrane Library, Scopus, and SPORTDiscus databases from inception to June 2023. <\/jats:p><jats:p> STUDY SELECTION CRITERIA: We included randomized controlled trials of exercise interventions in adults with nonspecific chronic LBP and at least 1 pain outcome reported at the main trial end point. <\/jats:p><jats:p> DATA SYNTHESIS: A random-effects network meta-analysis was conducted. We assessed risk of bias using the Cochrane Risk of Bias Tool 2.0, and used the GRADE approach to judge the certainty of evidence for each outcome. <\/jats:p><jats:p> RESULTS: Eighty-two trials were included (n = 5033 participants). We found a nonlinear dose-response relationship between total exercise and pain in patients with nonspecific chronic LBP. The maximum significant response was observed at 920 MET minutes (standardized mean difference = \u22121.74; 95% credible intervals: \u22122.43, \u22121.04). The minimal clinically important difference for achieving meaningful pain improvement was 520 MET minutes per week. The dose to achieve minimal clinically important difference varied by type of exercise; Pilates was the most effective. The certainty of the evidence was very low to moderate for all outcomes. <\/jats:p><jats:p> CONCLUSION: The dose-response relationship of different exercise modalities to improve pain in patients with nonspecific chronic LBP had a U-shaped trajectory and low- to moderate-certainty evidence. The clinical effect was most pronounced with Pilates exercise. J Orthop Sports Phys Ther 2024;54(5):315-327. Epub 8 March 2024. doi:10.2519\/jospt.2024.12153 <\/jats:p>","DOI":"10.2519\/jospt.2024.12153","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T16:28:42Z","timestamp":1709915322000},"page":"315-327","update-policy":"https:\/\/doi.org\/10.2519\/jospt.crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["The Best Exercise Modality and Dose for Reducing Pain in Adults With Low Back Pain: A Systematic Review With Model-Based Bayesian Network Meta-analysis"],"prefix":"10.2519","volume":"54","author":[{"given":"Zhide","family":"Liang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shudong","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanzhi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hengzhi","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingdanni","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianliang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1394","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e31821ece12"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.313.7066.1200"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jshs.2019.01.003"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2014.07.039"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2019.158489"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2020.1836269"},{"key":"bib7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.10.005"},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102955"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2019.04.010"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2019-101436"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f2304"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3767"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000001936"},{"key":"bib14","doi-asserted-by":"publisher","DOI":"10.3758\/s13423-018-01563-9"},{"key":"bib15","doi-asserted-by":"publisher","DOI":"10.1186\/s12998-016-0129-4"},{"key":"bib16","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2022.10671"},{"key":"bib17","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00098-X"},{"key":"bib18","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.07.005"},{"key":"bib19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30489-6"},{"key":"bib20","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00098-X"},{"key":"bib21","first-page":"Cd011279","volume":"4","author":"Geneen LJ","year":"2017","journal-title":"Cochrane Database Syst Rev."},{"key":"bib22","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2006.2270"},{"key":"bib23","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2021.0304"},{"key":"bib24","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(84)90615-9"},{"key":"bib25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.026"},{"key":"bib26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.01.011"},{"key":"bib27","doi-asserted-by":"publisher","DOI":"10.1097\/00043764-199803000-00008"},{"key":"bib28","first-page":"CD009790","volume":"9","author":"Hayden JA","year":"2021","journal-title":"Cochrane Database Syst Rev."},{"key":"bib29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2021.09.004"},{"key":"bib31","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1044"},{"key":"bib32","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"bib33","unstructured":"Higgins JPT Green S.  Cochrane Handbook for Systematic Review of Interventions. Version 5.1.0. The Cochrane Collaboration; 2011 Updated March 2011"},{"key":"bib34","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1687"},{"key":"bib35","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2010.10.002"},{"key":"bib36","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2022.101747"},{"key":"bib37","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2018-100035"},{"key":"bib38","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(03)00010-6"},{"key":"bib39","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2385"},{"key":"bib40","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2017.04.003"},{"key":"bib41","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199901010-00013"},{"key":"bib42","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.3915"},{"key":"bib43","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4425-7"},{"key":"bib44","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30970-9"},{"key":"bib45","doi-asserted-by":"publisher","DOI":"10.1002\/psp4.12091"},{"key":"bib46","doi-asserted-by":"publisher","DOI":"10.1007\/s00482-018-0353-z"},{"key":"bib47","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2019-100886"},{"key":"bib48","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1351"},{"key":"bib49","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2022.10612"},{"key":"bib50","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2008.07.004"},{"key":"bib51","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.775344"},{"key":"bib52","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.1046518"},{"key":"bib53","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2019006"},{"key":"bib54","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2012.09.002"},{"key":"bib55","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.38"},{"key":"bib56","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"bib57","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2012.3826"},{"key":"bib58","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2015.04.010"},{"key":"bib59","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.00822"},{"key":"bib60","doi-asserted-by":"publisher","DOI":"10.1016\/j.csda.2010.01.025"}],"container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jospt.org\/doi\/pdf\/10.2519\/jospt.2024.12153","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T13:49:21Z","timestamp":1724680161000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jospt.org\/doi\/10.2519\/jospt.2024.12153"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":59,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.2519\/jospt.2024.12153"],"URL":"https:\/\/doi.org\/10.2519\/jospt.2024.12153","relation":{},"ISSN":["0190-6011","1938-1344"],"issn-type":[{"value":"0190-6011","type":"print"},{"value":"1938-1344","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]},"assertion":[{"value":"2024-04-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}