Meta-analysis on the Effects of Exercise Therapy and Physiotherapy on Pain in Korean Patients with Chronic Low Back Pain

만성요통환자를 대상으로 운동치료 및 물리치료가 통증에 미치는 효과에 대한 메타분석

  • Kim, Sung-Kyu (The Graduate School of Education, Chung-Ang University) ;
  • Lim, Bee-Oh (The Graduate School of Education, Chung-Ang University)
  • Received : 2019.10.30
  • Accepted : 2020.01.20
  • Published : 2020.03.31


Objective: The purpose of this study was to investigate meta-analysis on the effects of exercise therapy and physiotherapy on pain in korean patients with chronic low back pain. Method: Meta-analysis was performed on the type and method of treatment. A total of 23 experimental studies were coding into 31 individual studies, into types, methods, visual analogue scale (VAS), each pre/post value of the effect size was calculated by meta-analysis. Results: Sling exercise, stretching, thermal therapy, kinesio-taping, lumbar stabilization exercise, electrotherapy is large effect size (ES ≥ .08). In addition, big effects occurred in order of treatment period is more than 9 weeks, three times a week. Conclusion: Our results indicated that persistent treatment of chronic back pain is the most effective method of self-sufficiency rather than temporary relief.


  1. Borenstein, M., Hedges, L. V., Higgins, J. P. T. & Rothstein, H. R. (2009). Introduction to meta-analysis. West Sussex. United Kingdom : John Wiley & Sons.
  2. Caillient, R. (1988). Low Back Pain, Ed 4. Philadelphia Journal of Sports Medicine. FA: Daves Company, 63-75.
  3. Carpenter, D. M. & Nelson, B. W. (1999). Low back strengthening for the prevention and treatment of low back pain. Medicine & Science in Sport & Exercise, 31, 18-24.
  4. Cohen, J. (1988). Statistical power for the behavioral sciences (2nd Ed). Hillsdale. New Zealand: Lawrence Erlbaum Associates.
  5. Choi, J. H. (2007). Effects of Ultrasonic and Laser Treatment on Back pain. Journal of the Korean Society of Physiological Treatment, 14(2), 76-84.
  6. Choi, S. Y. (2013). A Study on the Influence of Pelvic Spine Slope on Lumbar Diseases. Master's Degree Report to Unscheduled. Sunmoon University Graduate School of Integrated Medicine, Chungcheongnam-do.
  7. Deyo, R. A. & Weinstein, J. N. (2001). Low back pain. New England Journal of Medicine, 344(5), 363-370.
  8. Duval, S. J. & Tweedie, R. L. (2000). Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics, 56(2), 455-463.
  9. Edwards, R. H., Harris, R. C. & Hultman, E. (1972). Effect of temperature on muscle energy metabolism and endurance during successive isometric contractions, sustained to fatigue, of the quadriceps muscle in man. The Journal of Physiology, 31(2), 220-335.
  10. Elnaggar, I. M., Nordin, M., Sheikhzad, A., Parnianpour, M. & Kahanovitz, N. (1991). Effect of spinal flexion and extension exercise on low back pain and spinal mobility in chronic mechanical low back pain patient. Spine, 16(8), 967-972.
  11. Ferreira, P. H., Ferreira, M. L., Maher, C. G., Herbert, R. D. & Refshauge, K. (2006). Specific stabilisation exercise for spinal and pelvic pain: A systematic review. Journal of Physiotherapy, 52(2), 79-88.
  12. Gong, W. T. & Lee, S. Y. (2007). The effects of lumbar vertebrae mobilization and lumbar stabilizing exercise on lumbar muscle strength. Journal of the Korean Academy of Orthopedic Manual Physical Therapy, 13(2), 21-30.
  13. Hagen, E. M., Eriksen, H. R. & Ursin, H. (2000). Does early intervention with a light mobilization program reduce longterm sick leave for low back pain. Spine, 25(15), 1973-1976.
  14. Han, G. S., So, Y. Y. & Kim, G. D. (2013). Effect of Rehabilitation Training on the Muscle Strength, Flexibility, and Pain Variation of Chronic Back pain Patients with or without Knessio Tapings. Coaching Capability Development Site, 15(1), 98-106.
  15. Ha, Y. S., Lee, J. S., Kim, S. S. & Lee, B. H. (2012). The effect of sling exercise therapy and motor control exercise on pain, ADL performance and trunk muscle strength in patients with chronic low back pain. Journal of Oriental Rehabilitation Medicine, 22(3), 151-162.
  16. Heo, N. Y. (2014). Physical Treatment on Lumbar Perception. Master's Degree Report to Unscheduled. Korea National University of Physical Education Graduate School of Social and Physical Education, Seoul.
  17. Hides, J. A. & Jull, G. A. (2001). Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine, 26(11), 243-248.
  18. Hwang, S. D. (2014). Understanding the Easier Meta-analysis. Seoul: hakjisa, 15-20.
  19. Hyun, S. H., Kang, M. S. & Ryu, J. C. (2012). Effect of Vertical Tendon Treatment for Chronic Lumbar Pain Patients on the Lumbar Frontal Force and the Scoliosis and Lumbar Index. Journal of the Korean Association of Physical Education, 51(5), 679-688.
  20. Inani, S. B. & Selkar, S. P. (2013). Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain, a randomized clinical trial. Journal of Back and Musculoskeletal Rehabilitation, 26(1), 37-43.
  21. Jang, W. S. & Kim, J. W. (2018). A Study on the Effectiveness of the Noninvasive Treatment Method on the Scale of Pain and the Mitigation of the Lumbar Function Disorder Index: with a focus on patients with chronic lumbar pain. Journal of the Korea Sports Association, 16(1), 637-651.
  22. Janko, M. & Trontelj, J. V. (1980). Transcutanous electrical nerve stimulation: A microneurographic and peripheral study. Panin, 9, 219-230.
  23. Jung, D. I. & Kim, C. K. (2010). Changes in Pain and Body Functions of Chronic Back pain Patients in the Industry with Stabilization of the Swiss Ball Lumbar. Journal of Health Basic Medicine, 3(2), 72-76.
  24. Jung, E. H. (2015). Effects of motor motion and lumbar stabilization movement on the trunk activity and lumbar obstruction index of chronic lumbar pain sufferers. Master's Degree Report to Unscheduled. Nambu University Graduate School of Health and Management, Kwangju.
  25. Kang, T. Y. & Park, Y. S. (2013). Effects of Sling Exercise with PNF Technique on Pain and Balance in Chronic Low Back Pain Patients. The Korean Journal of Soluble Nerve Muscle Promotion, 11(1), 1-6.
  26. Kelly, S. (2015). Becoming a Supple Leopad. Seoul: therapy of daesung, 23-78, 150-167.
  27. Kim, G. D., Hong, M. Y., Han, G. S. & Jung, Y. H. (2016). Effects of parallel-implastic rehabilitation exercise, a Pneu-weight vertical dog, on the changes in the rate of roll and pain index in chronic back pain patients. Journal of the Korean Association of Physical Culture and Sports Chemistry, 25(6), 1383-1393.
  28. Kim, J. S., Lee, C. H., Cho, M. J., Lim, Y. O., Jung, C. S. & Kim, S. Y. (2005). Comparison of Exercise Effects around Abdominal Heart and Pyojae Muscle in Chronic Lumbar Patients. Journal of the Korean Society for the Treatment of Equal Variables, 11(1), 1-10.
  29. Kim, K. C. (1999). Back pain management strategy for primary care. Journal of the Korean Physical Treatment Society, 20(5), 634-646.
  30. Kim, S. G., Lee, S. W. & Kim, J. H. (2010a). Effects of Rehabilitation Exercise Program on Pain and Inflammation Indicators of Yoga Workers. Korean Association for the Advancement of Health Education, 10(3), 131-138.
  31. Kim, S. H. (2005). Measurement of the flexion of the body and the change in the strength and endurance of the temple in the application of tapping of chronic lumbar patients. Journal of the Korean Society for the Treatment of Equal Variables, 11(2), 40-48.
  32. Kim, S. H., Yoo, B. K. & Lee, Y. H. (2010b). Effects of Spine Stabilization Exercise on the Short-Section Area, Lumbar Muscle, and Subjective Pain Index of Lumbar Muscle in Patients with Back pain. Journal of the Korean Society of Social Sports, 40(2), 527-536.
  33. Kim, S. Y., Chae, J. B. & Kwon, J. H. (2001). A Technical Study on the Application Time of Physical Treatment for Back pain Patients. Journal of the Korean Society for the Physiological Treatment of Forms, 7(1), 51-66.
  34. Kirkesola, G. (2001). Sling exercise therapy (S-E-T): A total concept for exercise and active treatment of musculoskeletal disorders. Journal of Korean Orthopedic Manual Physical Therapy, 87-106.
  35. Ko, D. S., Lee, C. G., Kim, K. Y., Lee, K. I., Kim, M. H. & Jung, D. I. (2009). Variation of the Exercise Capacity of Chronic Back pain Patients in Industry with Lumbar Stabilization Movement. Journal of the Korean Society of Social Sports, 35(2), 1021-1028.
  36. Kudo, P., Dainty, K., Clarfield, M., Coughlin, L., Lavoie, P. & Lebrun, C. (2006). Randomized, placebo-controlled, double blind clinical trial evaluating the treatment of plantar fasciitis with an extracoporealshockwave therapy device: a North American confirmatory study. Journal of Orthopaedic Research, 24, 115-123.
  37. Kwak, K. I., Choi, H. Y. & Kim, J. Y. (2013). Effect of Lumbar Stabilization Exercise on the Depression and Function of Female Older People with Chronic Back pain. Journal of the Korea Entertainment Industry Association, 7(2), 117-123.
  38. Kwak, K. I. & Lim, J. H. (2011). Effects of Stabilization and Kidney Exercise on the Muscle and Pain in Patients with Chronic Back pain. Journal of the Korean Society of Clinical Electrophysiology, 9(2), 39-46.
  39. Kwon, G., Kim, C. M. & Park, S. J. (2018). Effects of highfrequency therapy on pain and disability index of patients with chronic back pain through the hands of physical therapists. Journal of the Korean Convergence Society, 9(2), 289-294.
  40. Kwon, W. A., Yang, K. H. & Lee, J. H. (2006). The effects on 3-dimensional exercise of lumbar stabilization for chronic low back pain. The Journal of Korean Society of Physical Therapy, 18(5), 25-34.
  41. Lee, C. W., Lee, I. S. & Kim, H. S. (2013). Effects of Equestrian Exercise on Pain and Body Flexibility in Patients with Chronic Back pain. Journal of the Korean Association of Integrated Medicine, 1(3), 111-118.
  42. Lee, D. J., Lee, H. J. & Han, S. W. (2012). Effects of back pain patients on the thickness of body muscles, maximum muscle strength, and pain according to the exercise program. Journal of the Korean Society of Social Sports, 49(2), 811-819.
  43. Lee, E. Y. (2003). Effect of Gymnastic Ball Exercise on Treatment of Chronic backache Patients. Master's Degree Report to Unscheduled. Chosun University Graduate School of Environmental Health, Gwangju.
  44. Lee, J. S. (2017). Effects of lumbar stabilization and stepbox walking exercises on functional movement, heart muscle area, health fitness and quality of life in patients with chronic back pain. Doctoral dissertation thesis. Sangmyung University Graduate School, Seoul.
  45. Lehman, J. F. & Delateur, B. J. (1990). Therapeutic Heat and Cold. Lippincott Williams & Wilkins, Baltimore. 102-137.
  46. Lim, S. Y., Kim, Y. J., Kim, T. G., Kim, J. D., Choi, J. H. & Kim, M. J. (2007). Comparison of Effectiveness of Spicy Room Treatment and Infrared Treatment in Patients with Chronic Back pain. Journal of Clinical Senior Citizens' Association, 8(4), 427-432.
  47. Littell, J., Corcoran, J. & Pillai, V. (2008). Systematic Reviews and Meta-Analysis. New York: Oxford university press.
  48. Magee, D. J. (1999). Indtability and stabilization, Theory and treatment, second. FA: Seminar Workbook.
  49. Mather, C. G. (2004). Effective physical treatment for chronic low back pain. Orthopedic Clinics of North America, 35(1), 57-64.
  50. McGill, S. M. (2001). Low Back Stability: From Formal Description to Issues for Performance and Rehabilitation, Exercise, sport. Science. Rewards, 29(1), 26-31.
  51. Min, K. O. (1993). Electrotherapy. Seoul: Hyeonmunsa, 103-133.
  52. Nam, G. W. & Kim, J. S. (2005). Improvement and maintenance of interstitial stability according to dynamic lumbar stabilization movement after removal of open microscopic lumbar sign. Journal of the Korean Society for the Physiological Treatment of Forms, 11(1), 37-48.
  53. Nam, H. C. & Cho, Y. H. (2010). Effect of Kineshio Tapping on the Exercise Program of Lumbar Patients. Journal of the Korean Association of Physical Education, 49(4), 429-436.
  54. O'Sullivan, P. B. & Phyty, G. D. (1997). Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine, 22(24), 2959-2967.
  55. Paek, Y. W., Min, S., Lee, B. H. & Shin, M. G. (2014). Changes in Pain, Muscle Strength and Flexibility according to Pinch Lift and Rubbing Manual Therapy and Stretching Application for Low Back Pain. Journal of Korean Biological Nursing Science, 16(1), 1-7.
  56. Park, J. B. & Anh, S. H. (2017). Effects of lumbar stabilization and combined exercise on muscle strength, pain, and activity disorder index of patients in the chronic pain. Journal of the Korean Association of Physical Education and Sports Science, 26(3), 1019-1031.
  57. Park, S. J. (2010). Effects of External Surfactory Low Frequency Treatment on People with Smoking and Non-Smoking Lumbar Painting. Unpublished master's thesis. Yongin University Graduate School of Physiotherapy Science, Gyeonggi Province.
  58. Park, S. W. & Oh, J. G. (2018). Effects of the Long-and Short-Term Exercise Program on the Abdominal Muscular Force and Pain and Daily Activity Disorder Level of Patients with Chronic Back pain with Stabilization of the Spine and MEDX Divine Exercise. Sports Science, 35(2), 61-69.
  59. Rosenthal, R. & Rosnow, R. S. (1984). Essentals of Behavieral Research: Method and Data Analysis. New York: Mcgraw-Hill, 38-47.
  60. Rubin, A. (2008). Practitioner's Guide to Using Research for Evidence-Based Practice. Hoboken, New Jersey: John Wiley & Sons, 50-71.
  61. Shin, W. & Lee, K. R. (2013). Effects of Stabilizing Exercise Program on Pain Perception and Lumbar Muscle Activity in Back pain patients. Journal of the Korea Sports Association, 11(4), 415-423.
  62. Smith, M. & Glass, G. (1977). Meta-analysis of psychotherapy outcome studies. American Psychological Association, 32, 752-760.
  63. So, J. M. & Lee, C. G. (2006). A Fatigue Analysis on Lumbar Extension Muscle during Repeated Trunk Extention. Korean Journal of Sport Biomechanics, 16(1), 159-166.
  64. Yoon, J. Y., Jang, M. G., Hyun, S. J. & Yoon, B. C. (2011). Effects of Combined Application of High-ressure Oxygen and Physical Treatment on the Mitigation of Chronic Back pain in the Elderly. Journal of the Korean Physical Treatment Society, 23(4), 23-28.