Effects of breathing exercises on low back pain in clinical: A systematic review and meta-analysis

Jiao Shi; Zhen Liu; Xingchen Zhou; Fanyuan Jin; Xiaojie Chen; Xiaodong Wang; Lijiang Lv

doi:10.1016/j.ctim.2023.102993

Effects of breathing exercises on low back pain in clinical: A systematic review and meta-analysis

Complement Ther Med. 2023 Dec:79:102993. doi: 10.1016/j.ctim.2023.102993. Epub 2023 Oct 10.

Authors

Jiao Shi¹, Zhen Liu¹, Xingchen Zhou¹, Fanyuan Jin², Xiaojie Chen³, Xiaodong Wang⁴, Lijiang Lv⁵

Affiliations

¹ The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China.
² The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China.
³ 72nd Group Army Hospital of Chinese People's Liberation Army.
⁴ The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China. Electronic address: wangxdong@126.com.
⁵ The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China. Electronic address: lvlijiang0288@163.com.

PMID: 37827444
DOI: 10.1016/j.ctim.2023.102993

Abstract

Objective: This study aims to systematically evaluate the effect of breathing exercises on the low back pain (LBP).

Methods: The studies of relevant randomized controlled trials (RCTs) testing the effect of breathing exercises on LBP were selected after strict screening from the establishment of PubMed, EMBASE, Cochrane Library, Web of Science, CBM, and CNKI databases until September 2022. The studies included were then independently assessed for risk bias by two investigators. The PRISMA 2020 statement was followed in this study.

Results: 11 RCTs involving 383 patients were included in this analysis. Results showed that the effective rate of LBP patients after breathing exercises was significantly higher than those in the control group, and the VAS (Visual Analogue Score) and ODI (Oswestry Disability Index) scores of LBP patients were significantly lower than those in the control group [VAS: MD = -0.50, 95% CI (-0.88, -0.11), I² = 76%, p = 0.0009; ODI: MD = -2.46, 95% CI (-3.41, -1.52), I² = 20%, p = 0.28]. The results of subgroup showed that the duration of treatment had little effect on the effect of breathing exercises, and breathing exercises alone could also have a positive effect on LBP. However, there were methodological limitations in the included studies, future studies should ensure blinded outcome assessors and full reporting to reduce bias risks. Because this review is a study of breathing exercises as an intervention without any adverse events, all studies did not involve safety assessments.

Conclusions: The results indicated that breathing exercises have a positive effect on alleviating LBP, but due to the lack of methodological rigor and some limitations of the included studies, more critical RCTs are still needed in the future to verify the precision of this conclusion. The protocol was registered in PROSPERO (No. CRD42022345561).

Keywords: Breath training; Low back pain; Meta-Analysis.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Breathing Exercises
Exercise
Exercise Therapy / methods
Humans
Low Back Pain* / therapy
Respiration