Appraisal of Low Back Pain Prevention Exercise Program

Appendix
Paper for appraisal- “Improvement of lumbar motor control and trunk muscle conditions with a
novel low back pain prevention exercise program”
CASP Checklist
1) Did the study address
a clearly focused
issue?
No, the title of the study was generic and did not mention
that the research was specifically conducted on ballet women
dancer. The intervention “novel low back pain prevention
exercise program” was also not specific.
2) Did the authors use an
appropriate method to
answer their question?
A case control study was an appropriate way of answering
the question for this research and I believe the study question
was addressed properly.
3) Were the cases
recruited in an
acceptable way?
The participants were defined precisely that is they were
ballet dancers as low back pain is frequent among ballet
dancers. All the participants were representative of that
population. However, the number of participants were low.
4) Were the controls
selected in an
acceptable way?
The controls belonged to the same population group that is
ballet dancers, belonging to the same average age (14.86 ±
1.00 years) as that of the intervention group (14.91 ± 1.37
years). However, the number of participants in this group
was also less which may compromise the generalizability of
the results.
5) Was the exposure
accurately measured to
minimise bias?
The authors used the objective measurements which is one
way of reducing the retrospective biasing. The measures
truly reflected what they are supposed to measure.
6) Aside from the
experimental
intervention, were the
groups treated
equally?
Yes
7) How large was the
treatment effect?
The pain intensity that was examined during training with
visual analog scale, the habitual posture with
photogrammetry, the abdominal muscle strength with Kraus-
Weber test, the static muscle strength of the trunk muscles
with core test and the lumbar motor control with leg
lowering test. I believe the analysis was appropriate for the
design.
8) How precise was the
estimate of the
treatment effect?
In the intervention group the intensity of pain significantly
decreased (VAS1: p = 0.012; VAS2: p = 0.021), the
abdominal muscle strength significantly improved (K-W. B:
p=0.025; K-W. C: p<0.001), the static muscle strength of
trunk muscles significantly increased (Core-test: p<0.001)
and the lumbar motor control significantly improved in both

legs (Leg low. R.: p<0.001; Leg low. L.: p<0.001). Also, the
habitual posture greatly improved (frontal view: 34.78%,
side view: 52.17%).
9) Do you believe the
results?
Yes I believe the results as the research designs and methods
are appropriate make the results reliable.
10) Can the results be
applied to the local
population?
The subjects covered in the study are only ballet dancers and
the sample size is small in number so the it is not sufficiently
same to the general population.
11) Do the results of this
study fit with other
available evidence?
Yes
Paper for appraisal- “A Systematic Review of the Effects of Exercise and Physical Activity on
Non-Specific Chronic Low Back Pain”
1) Did the review address a
clearly focused question?
The review is clearly focused and addresses a direct
question. The focus in terms of intervention studied that
is exercise and physical activity. It is also focused in
terms of the population which is people suffering from
non-specific chronic low back pain. The title of the
article mentions the type of research study that is
systematic review. The mention of the study type in in
the title, makes it easily searchable in the database. The
review question is clearly focused and explanatory and
fulfil its key function of clarifying the aim of the study
for the readers.
2) Did the authors look for
the right type of papers?
The intervention programmes were identified using the
search terms “non-specific chronic low back pain and
exercise” which returned 141 results. Other search terms
included “chronic low back pain and aerobic exercise”

(187 results), “chronic low back pain and muscular
strength” (120 results) and “non-specific chronic low
back pain” (173 results). A total of 14 studies were
included within the final review.
3) Do you think all the
important, relevant studies
were included?
A review of the literature was carried out using the
databases SPORTDiscuss, Medline and Google Scholar.
4) Did the review’s authors
do enough to assess
quality of the included
studies?
The study lack the elaboration of how the quality of the
included studies were assessed.
5) If the results of the review
have been combined, was
it reasonable to do so?
Yes
6) What are the overall
results of the review?
Exercise intervention programmes involving either
muscular strength, flexibility or aerobic fitness is
beneficial for NSCLBP but not acute low back pain.
7) How precise are the
results?
the results of this research study was adequately precise
8) Can the results be applied
to the local population?
The results are not likely to be applicable as the number
of studies included in the review was very less and even
those were included were not assessed for their quality.
9) Were all important I believe that all the significant outcomes were