RT Journal Article SR Electronic T1 Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis JF British Journal of Sports Medicine JO Br J Sports Med FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine SP 1279 OP 1287 DO 10.1136/bjsports-2019-100886 VO 54 IS 21 A1 Patrick J Owen A1 Clint T Miller A1 Niamh L Mundell A1 Simone J J M Verswijveren A1 Scott D Tagliaferri A1 Helena Brisby A1 Steven J Bowe A1 Daniel L Belavy YR 2020 UL http://bjsm.bmj.com/content/54/21/1279.abstract AB Objective Examine the effectiveness of specific modes of exercise training in non-specific chronic low back pain (NSCLBP).Design Network meta-analysis (NMA).Data sources MEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL.Eligibility criteria Exercise training randomised controlled/clinical trials in adults with NSCLBP.Results Among 9543 records, 89 studies (patients=5578) were eligible for qualitative synthesis and 70 (pain), 63 (physical function), 16 (mental health) and 4 (trunk muscle strength) for NMA. The NMA consistency model revealed that the following exercise training modalities had the highest probability (surface under the cumulative ranking (SUCRA)) of being best when compared with true control: Pilates for pain (SUCRA=100%; pooled standardised mean difference (95% CI): −1.86 (–2.54 to –1.19)), resistance (SUCRA=80%; −1.14 (–1.71 to –0.56)) and stabilisation/motor control (SUCRA=80%; −1.13 (–1.53 to –0.74)) for physical function and resistance (SUCRA=80%; −1.26 (–2.10 to –0.41)) and aerobic (SUCRA=80%; −1.18 (–2.20 to –0.15)) for mental health. True control was most likely (SUCRA≤10%) to be the worst treatment for all outcomes, followed by therapist hands-off control for pain (SUCRA=10%; 0.09 (–0.71 to 0.89)) and physical function (SUCRA=20%; −0.31 (–0.94 to 0.32)) and therapist hands-on control for mental health (SUCRA=20%; −0.31 (–1.31 to 0.70)). Stretching and McKenzie exercise effect sizes did not differ to true control for pain or function (p>0.095; SUCRA<40%). NMA was not possible for trunk muscle endurance or analgesic medication. The quality of the synthesised evidence was low according to Grading of Recommendations Assessment, Development and Evaluation criteria.Summary/conclusion There is low quality evidence that Pilates, stabilisation/motor control, resistance training and aerobic exercise training are the most effective treatments, pending outcome of interest, for adults with NSCLBP. Exercise training may also be more effective than therapist hands-on treatment. Heterogeneity among studies and the fact that there are few studies with low risk of bias are both limitations.