Effects of Mind-Body Exercises on Pain Intensity in Individuals with Chronic Nonspecific Low Back Pain: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.
4 affiliations
- 1College of Wushu, Shanghai University of Sport, Shanghai, People's Republic of China.
- 2Department of Physical Education, Beijing Hongzhi Middle School, Beijing, People's Republic of China.
- 3China Wushu School, Beijing Sport University, Beijing, People's Republic of China.
- 4Hebei Sport University, Shijiazhuang, Hebei, People's Republic of China.
Abstract
Objective
To synthesize the effects of mind-body exercises (MBEs) on pain in adults with chronic nonspecific low back pain (CNLBP) and assess whether comparative and study-level dose evidence can inform exercise selection.Methods
We searched 10 databases from inception to 11 July 2026 for randomized controlled trials. Random-effects pairwise meta-analysis compared MBEs with control conditions. Network meta-analysis (NMA) compared yoga, Pilates, Tai Chi (TC), and qigong. Exploratory subgroup analyses and meta-regression evaluated intervention duration, frequency, session duration, weekly exercise volume, and comparator type. Risk of bias and certainty of evidence were assessed using the Cochrane Risk of Bias 2 tool (RoB 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, respectively.Results
Twenty-five randomized controlled trials were included. MBEs reduced pain on a 0-10-cm visual analog scale compared with control conditions (mean difference, -1.56 cm; 95% confidence interval, -1.98 to -1.15). Heterogeneity was substantial, with an I-squared statistic of 92.7%, and the 95% prediction interval ranged from -3.69 to 0.56 cm. No statistically significant subgroup differences were identified for intervention duration, frequency, session duration, or weekly exercise volume. Comparator type was associated with study-level effect estimates (P = 0.0036). In the NMA, all four MBEs had lower estimated pain scores than the control node, but no between-modality differences were detected. TC had the highest surface under the cumulative ranking curve (SUCRA) value (85.4%). The certainty of evidence was low for all network comparisons assessed.Conclusion
MBEs may reduce pain intensity in adults with CNLBP. However, substantial heterogeneity, uncertainty in transitivity, and low certainty of evidence limit confidence in comparative estimates. The available evidence does not establish a preferred MBE modality or an optimal exercise dose.
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BibTeX
@article{xiang2026effects,
title = {{Effects of Mind-Body Exercises on Pain Intensity in Individuals with Chronic Nonspecific Low Back Pain: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.}},
author = {Yi Xiang and Zengao Lu and Liang Li and Tonggang Fan},
journal = {Journal of pain research},
year = {2026},
month = oct,
doi = {10.2147/jpr.s650628},
url = {https://europepmc.org/article/MED/42899197},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Effects of Mind-Body Exercises on Pain Intensity in Individuals with Chronic Nonspecific Low Back Pain: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.
AU - Yi Xiang
AU - Zengao Lu
AU - Liang Li
AU - Tonggang Fan
PY - 2026
DA - 2026/10/15
JO - Journal of pain research
DO - 10.2147/jpr.s650628
UR - https://europepmc.org/article/MED/42899197
AB - Objective To synthesize the effects of mind-body exercises (MBEs) on pain in adults with chronic nonspecific low back pain (CNLBP) and assess whether comparative and study-level dose evidence can inform exercise selection.Methods We searched 10 databases from inception to 11 July 2026 for randomized controlled trials. Random-effects pairwise meta-analysis compared MBEs with control conditions. Network meta-analysis (NMA) compared yoga, Pilates, Tai Chi (TC), and qigong. Exploratory subgroup analyses and meta-regression evaluated intervention duration, frequency, session duration, weekly exercise volume, and comparator type. Risk of bias and certainty of evidence were assessed using the Cochrane Risk of Bias 2 tool (RoB 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, respectively.Results Twenty-five randomized controlled trials were included. MBEs reduced pain on a 0-10-cm visual analog scale compared with control conditions (mean difference, -1.56 cm; 95% confidence interval, -1.98 to -1.15). Heterogeneity was substantial, with an I-squared statistic of 92.7%, and the 95% prediction interval ranged from -3.69 to 0.56 cm. No statistically significant subgroup differences were identified for intervention duration, frequency, session duration, or weekly exercise volume. Comparator type was associated with study-level effect estimates (P = 0.0036). In the NMA, all four MBEs had lower estimated pain scores than the control node, but no between-modality differences were detected. TC had the highest surface under the cumulative ranking curve (SUCRA) value (85.4%). The certainty of evidence was low for all network comparisons assessed.Conclusion MBEs may reduce pain intensity in adults with CNLBP. However, substantial heterogeneity, uncertainty in transitivity, and low certainty of evidence limit confidence in comparative estimates. The available evidence does not establish a preferred MBE modality or an optimal exercise dose.
SN - 1178-7090
ER -