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Exercise for the primary prevention of low back pain
  1. Rahman Shiri
  1. Finnish Institute of Occupational Health, Helsinki, Finland
  1. Correspondence to Dr Rahman Shiri, Finnish Institute of Occupational Health, P.O. Box 40, Helsinki FI-00251, Finland; rahman.shiri{at}

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The effect of exercise on primary prevention of low back pain (LBP) is uncertain. Saragiotto and Latimer1 summarised a recent meta-analysis of eight randomised controlled trials (RCTs, 11 reports) by Steffens et al.2 I have several major concerns regarding that meta-analysis.2

First, primary studies were incompletely identified using an inappropriate search strategy and symbols. Neither Embase nor the Cochrane Library uses a dollar sign ($), but an asterisk (*) as a truncation symbol to search for one or more missing characters. The authors2 identified 3.2 times more publications in Embase than in MEDLINE, and only …

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  • Funding The study is supported by the Finnish Ministry of Education and Culture (grant no 253715).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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