Exercise Interventions for Pain and Function in Older Adults with Low Back Pain: A Systematic Review

Dilfu Ahsan Zahrudin; Andrew Wijaya Saputra

doi:10.24843/mifi.000001809

Authors

Dilfu Ahsan Zahrudin Physiotherapy Program, Vocational Education Program, University of Indonesia, Depok, West Java 16424, Indonesia Author https://orcid.org/0009-0004-2047-4825
Andrew Wijaya Saputra Physiotherapy Program, Vocational Education Program, University of Indonesia, Depok, West Java 16424, Indonesia Author https://orcid.org/0009-0004-9750-4973

DOI:

https://doi.org/10.24843/mifi.000001809

Keywords:

Exercise Therapy, Low Back Pain, Aged, Physical Function, Muscle Strength

Abstract

Background: Chronic low back pain (LBP) is highly prevalent among older adults and contributes to functional decline and reduced quality of life. Exercise therapy is widely recommended; however, the effectiveness of different exercise modalities remains unclear.

Objective: To evaluate the effectiveness of exercise interventions on pain, physical function, and muscle strength in older adults with chronic low back pain.

Methods: This systematic review followed PRISMA 2020 guidelines. Four databases (Scopus, PubMed, Google Scholar, and Semantic Scholar) were searched from January 2015 to January 2026. Randomized controlled trials involving adults aged ≥60 years were included. Study selection and data extraction were conducted by two independent reviewers. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Data were synthesized narratively due to heterogeneity.

Results: Five randomized controlled trials involving 473 participants were included. PEDro scores ranged from 6 to 7, indicating good methodological quality. Exercise interventions, including Dynamic Neuromuscular Stabilization (DNS), corrective exercises, neuromuscular electrical stimulation (NMES), and biofeedback-based training, improved functional outcomes such as gait speed, balance (Timed Up and Go), and disability indices. However, quantitative effect sizes, confidence intervals, and p-values were not consistently reported across studies, limiting direct comparison of intervention effectiveness. No intervention demonstrated consistent superiority across all outcomes.

Conclusion: Exercise interventions improve physical function and reduce disability in older adults with chronic LBP, although effects on pain vary. The overall certainty of evidence is moderate due to heterogeneity and methodological limitations. Individualized exercise programs are recommended.