Gismael M Tarão, João Pedro R Afonso, Alex S Ribeiro, Marieli R Stocco, Adriana Bovi, Ludymilla V Barbosa, André L Pinto, Claudia S Oliveira, Karla C N de Carvalho, Miriã C Oliveira, Fernanda S P Quirino, Glauber A Oliveira, Andréia C R I Sampaio, Dunya O Masri, Luís V F Oliveira, Tiago V Fernandes, Hustênio A A Filho, Paolo Capodaglio, Luciana P Maia, Rodrigo A C Andraus
Limited evidence suggests that school-based exercise may reduce pain intensity and pain prevalence over six months and improve selected physical outcomes in adolescents aged 12-15 years. The small, heterogeneous evidence base and risk of bias preclude conclusions or recommendations regarding modality or dosage.
BACKGROUND/OBJECTIVES: To synthesize the effects of school-based exercise interventions in adolescents with nonspecific low back pain.
METHODS: PubMed/MEDLINE, Scopus, Web of Science, CENTRAL, PEDro, ScienceDirect, and supplementary sources were searched through 21 May 2026. Randomized and quasi-randomized controlled trials involving adolescents aged 10-19 years and delivering exercise wholly or substantially within schools were eligible. Risk of bias was assessed using Cochrane RoB 1, and findings were synthesized narratively.
RESULTS: Of 1935 records, two randomized trials and one quasi-experimental controlled trial (194 allocated participants) were included. Fanucchi et al. reported between-group reductions in past-month pain of 2.2 cm on a 10-cm visual analogue scale (95% CI 1.0-3.5) at 3 months and 2.0 cm (95% CI 0.5-3.5) at 6 months; absolute reductions in 3-month low back pain prevalence were 24% (95% CI 4-41) and 40% (95% CI 18-57), respectively. Jones et al. reported a large effect size for pain severity after 8 weeks (ES = 1.47). Javadipour et al. reported favorable pain and motor-function outcomes, but incomplete and internally inconsistent reporting limited interpretation. No study assessed low-back-pain-related disability using a validated instrument. All studies had high risk of bias in at least one domain, most commonly blinding. Heterogeneity precluded meta-analysis.
CONCLUSIONS: Limited evidence suggests that school-based exercise may reduce pain intensity and pain prevalence over six months and improve selected physical outcomes in adolescents aged 12-15 years. The small, heterogeneous evidence base and risk of bias preclude conclusions or recommendations regarding modality or dosage.