الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This systematic review aimed to collate evidence from all high-quality studies (Randomized Controlled Trials) available that fits the pre-specified eligibility criteria in order to answer the specific research question regarding which type of exercise interventions is the most effective for the management of adults with chronic nonspecific LBP and to what extent different characteristics of patients could explain heterogeneity in pain and disability outcomes. It aims to minimize bias by using explicit, systematic methods. A comprehensive literature search with documented search strategy upon how to search using keywords and MeSH terms. The studies retrieved from the search screened through title and abstract first followed by full text screening. Then, data extracted from the studies judged to be included in the review for three main purposes namely, critical appraisal or risk of bias assessment, qualitative synthesis or text description and quantitative synthesis or meta-analysis. The statistical heterogeneity shown from meta-analysis explored through subgroup analysis and meta-regression to assess which study characteristics could explain the variability of exercise effect. Possible associations between average population age, baseline pain or disability levels, exercise type, its dose and exercise effect size were suggested. Despite that this meta-analysis was powered to detect the overall main effect exercise, the power seems quite low among some subgroups to detect the relationship between subgroup membership and effect size, or between covariate values and effect sizes in case of meta-regression analyses of individual covariates. There is a need for more studies with more participants within each study characteristics’ subgroups to reach optimal information size that could confirm interpretation of the effect estimates by subgroup and meta- regression analysis.
GRADE evidence profile was used to summarize the key findings of the review with detailed assessment of all factors determining the certainty of the evidence. Certainty of the results presented through assessment to five domains of risk of bias, publication bias,
imprecision, inconsistency, and indirectness. Based on GRADE assessment, there is a moderate certainty of evidence of exercise therapy moderate effect that is exercise is likely results in a reduction in pain and disability outcomes. Exercise is highly recommended specially when compared to doing nothing. With regards to weighing benefits against risks.
6.1 Implications for practice
Exercise intervention is a promising non-pharmacological intervention for patients with chronic non-specific low back pain. It lowers pain and disability and improves quality of life, physical and mental health status. A therapeutic regimen of at least 8 weeks could be effective, and a longer intervention duration may sustain its effect to a greater extent. We emphasize the resistance and core stability modes of exercise training as the most effective specially for young adherent patients with symptoms of greater than a year but not more than ten years, the category of patients who may benefit the best.
6.2 Implications for research
Future research on the exercise role in LBP should take into consideration the impact of patients’ characteristics as their initial level of fear of pain, disability, and co-morbidity, whether baseline disability that is moderate to severe attenuates the therapeutic effect on disability. Moreover, measuring adherence using rating scales could help in between studies comparison together with other exercise features as its intensity, frequency, and duration.
Conclusion
We strongly recommend therapeutic exercises as effective interventions with no reported adverse effects; specifically, resistance and stabilization training should be given superiority witha focus on compliance and duration for sustainability effect.