Eficacia del ejercicio terapéutico en el manejo del dolor lumbar crónico: revisión sistemática ampliada

• Autores: Ignacio Conde Arias, Ana María Lascorz Goicoechea, Andrea Fumanal Escartín, Teresa Sierra Pascual, Raquel Magaz Montaner, Patricia Costa Rodriguez
• Localización: Revista Sanitaria de Investigación, ISSN-e 2660-7085, Vol. 6, Nº. 9, 2025
• Idioma: español
• Enlaces
  • Texto completo
• Resumen
  • español

    Objetivo: Evaluar la eficacia del ejercicio terapéutico en pacientes con dolor lumbar crónico, analizando su impacto en el dolor, la discapacidad funcional, la calidad de vida y el retorno laboral.

    Metodología: Se realizó una revisión sistemática ampliada en PubMed, PEDro, Scopus y Cochrane⁹ hasta junio de 2025. Se incluyeron ensayos clínicos aleatorizados y estudios controlados que comparaban programas de ejercicio (aeróbico, fortalecimiento, estabilidad central, yoga, pilates, terapia cognitivo-funcional) con cuidados habituales o placebo. Los desenlaces principales fueron intensidad del dolor (EVA, VAS), discapacidad (Roland-Morris, Oswestry Disability Index), calidad de vida (SF-36, EQ-5D) y reincorporación laboral.

    Resultados: Se analizaron 55 estudios con 7.200 pacientes. El ejercicio terapéutico redujo el dolor en un promedio de 2,5 puntos en EVA, mejoró la discapacidad (−15 puntos en ODI), aumentó la calidad de vida y duplicó la tasa de retorno laboral respecto al tratamiento estándar. Los programas de core stability³⁻⁴ y ejercicio cognitivo-funcional⁵⁻⁶ mostraron mayor eficacia a medio plazo, mientras que las intervenciones multimodales fueron las más efectivas en el mantenimiento de beneficios.

    Conclusiones: El ejercicio terapéutico es una intervención de primera línea en el dolor lumbar crónico, con beneficios clínicamente significativos y sostenibles.

  • English

    Objective: To evaluate the effectiveness of therapeutic exercise in chronic low back pain patients, analyzing its impact on pain, disability, quality of life, and return to work.

    Methods: An extended systematic review was conducted in PubMed, PEDro, Scopus, and Cochrane⁹ until June 2025. Randomized controlled trials comparing exercise programs (aerobic, strengthening, core stability³⁻⁴, yoga, pilates, cognitive-functional therapy) with usual care or placebo were included. Primary outcomes were pain intensity (VAS), disability (Roland-Morris, Oswestry Disability Index), quality of life (SF-36, EQ-5D), and return to work.

    Results: Fifty-five studies with 7,200 patients were analyzed. Therapeutic exercise reduced pain by an average of 2.5 VAS points, improved disability (−15 ODI points), enhanced quality of life, and doubled return-to-work rates compared to standard treatment. Core stability and cognitive-functional exercise were most effective in the mid-term, while multimodal interventions maintained long-term benefits.

    Conclusions: Therapeutic exercise is a first-line intervention for chronic low back pain, with clinically significant and sustainable benefits.

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