Jan Kool ^A1, Rob de Bie ^A4, Peter Oesch ^A3, Otto Knüsel ^A2, Piet van den Brandt ^A4, Stefan Bachmann ^A2
A1 Research Department Rehabilitation Centre Valens Switzerland
^A2 Department of Rheumatology Rehabilitation Centre Valens Switzerland
^A3 Work Rehabilitation Rehabilitation Centre Valens Switzerland
^A4 Department of Epidemiology Maastricht University The Netherlands

DOI: 10.1080/16501970310020104

Objectives: To investigate whether exercise alone or as a part of a multidisciplinary treatment reduces sick leave in patients with non-specific non-acute low back pain. Methods: A meta-analysis of randomized controlled trials was performed. A qualitative analysis of the sick leave results was performed applying pre-defined levels of evidence. In studies comparing exercise with usual care, pooled effect sizes were computed. Results: Fourteen trials were identified allowing 22 comparisons between treatments. The qualitative and the quantitative analysis showed strong evidence that exercise reduces sick days during the first follow-up year, the effect size (95% confidence interval) was -0. 24 ( -0. 36, -0. 11). In a subgroup of studies on the treatment of severely disabled patients (>90 sick days under usual care) the effect size was -0. 30 (-0. 42, -0. 17). The effect size of the number of patients receiving a disability allowance was small and not significant. Conclusion: The reviewed trials provide strong evidence that exercise significantly reduces sick days during the first follow-up year.