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Discussion
Specifying the treatment targets of exercise interventions: do we?
  1. Lianne Wood1,2,
  2. Rachel Ogilvie3,
  3. Jill A Hayden3
  1. 1 Spinal Surgery, Queen's Medical Centre Nottingham University Hospital NHS Trust, Nottingham, UK
  2. 2 School for Primary, Community and Social Care, Keele University, Newcastle under Lyme, UK
  3. 3 Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
  1. Correspondence to Lianne Wood, School for Primary, Community and Social Care, Keele University, Newcastle ST5 5BG, UK; l.wood2{at}keele.ac.uk

https://doi.org/10.1136/bjsports-2020-101981

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    Persistent non-specific low back pain (NSLBP) is the leading cause of disability worldwide.1 Although exercise is the most recommended intervention for NSLBP,2 the effects are small to moderate.3 Researchers who conduct and publish exercise-focused randomised controlled trials (RCTs) (clinicians/scientists) are doing a ‘poor to moderate’ job reporting.4 Gaps in reporting limit evidence synthesis and the ability of clinicians to replicate the exercises in a clinical setting.

    The CONSORT statement and the Template for Intervention Description and Replication checklist aim to improve minimum reporting standards. More recently, the Consensus on Exercise Reporting Template (CERT) was developed to work alongside the existing RCT checklists. Authors and journal editors need to embrace these standards to ensure a high quality of research conduct and implementation. If you work in exercise medicine/science and do not yet know ‘CERT’, we encourage you to study it and use it.

    Despite CERT adding value for our community, it fails to address the aim or target of the exercise intervention.5 Related to the content of this discussion—low back pain—our call to action is that researchers should be clear on the purpose of exercise treatment. For example, is the purpose of exercise therapy to reduce pain, to make the patient stronger or to improve function? Understanding the aim of the exercise therapy will impact the selection of the exercise intervention and RCT design.5 Clearly, specified target(s) of exercise are helpful—yoga, may aim to increase strength and flexibility as well …

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    Footnotes

    • Twitter @Woodwickslianne

    • Contributors All authors have contributed equally to the development of this manuscript, from idea inception, to data extraction and checking and manuscript editing.

    • Funding This paper was developed as a result of a Travel Fellowship awarded to LW by the Society of Back Pain Research, UK. LWs PhD is funded by the Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Faculty of Medicine and Health Sciences, Keele University. A grant from Nova Scotia Health Research Foundation (now Research Nova Scotia), partially funded the ongoing Cochrane review update providing data for this study.

    • Competing interests JAH reports a grant from Nova Scotia Health Research Foundation (now Research Nova Scotia) (2011), which partially funded the Cochrane review update providing data for this study. RO reports grants from Nova Scotia Health Research Foundation (2011), received by her institution, during the conduct of the study. LW reports a grant from the Versus Arthritis Primary Care Centre (2017–2020) to fund her PhD, and the Society of Back Pain Research (2019) which enabled the collaboration for this study.

    • Patient consent for publication Not required.

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