Active physiotherapy showed better results than passive physiotherapy for the management of non-specific chronic LBP: study

Written By : Dr Supreeth D R Published On 2025-10-31T20:15:47+05:30 | Updated On 31 Oct 2025 8:16 PM IST

Chronic low back pain (cLBP) is common. Physiotherapy is frequently indicated as a non-pharmacological management of these patients. Baroncini et al published an article in 'Journal of Orthopaedics and Traumatology'. This Bayesian network meta-analysis compared active versus passive physiotherapy versus their combination in terms of pain and disability in patients with mechanical and/or non-specific cLBP.

In June 2025, the Baroncini et al accessed - PubMed, Web of Science, Google Scholar and Embase. All the randomised controlled trials (RCTs) which evaluated the efficacy of a physiotherapy program in patients with LBP were accessed. Data regarding pain scores, the Roland–Morris Disability Questionnaire (RMQ) and the Oswestry Disability Index (ODI) were collected. The network meta-analyses were performed using the STATA (version 14; StataCorp, College Station, TX, USA) routine for Bayesian hierarchical random-effects model analysis, employing the inverse variance method. The standardised mean difference (STD) was used for continuous data.

The key findings of the study were:

• Data from 2768 patients (mean age 46.9 ± 10.9 years, mean BMI 25.8 ± 2.9 kg/m2) were collected.

• The mean length of follow-up was 6.2 ± 6.1 months.

• Between groups, comparability was found at baseline in terms of mean age, proportion of women, mean BMI, symptom duration and patient-reported outcome measures (PROMs).

• By the end of the follow-up period, the active group evidenced the lowest pain scores (SMD 1.00; 95% CI −3.28 to 5.28).

• The active group evidenced the lowest RMQ score (SMD 0.94; 95% CI –4.96 to 3.09).

• The active group evidenced the lowest ODI score (SMD −1.23; 95% CI −9.83 to 7.36).

The authors concluded – “Active physiotherapy showed better results than passive physiotherapy and a combination of both for the management of mechanical and/or non-specific, chronic LBP.”

Level of evidence: Level I, Bayesian network meta-analysis of RCTs.

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.