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Systematic Review

Effects of Exercise-Based Rehabilitation on Lumbar Degenerative Disc Disease: A Systematic Review

1
Department of Physical Education, Farhangian University, P.O. Box 889-14665, Tehran 19396-14464, Iran
2
Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil 56199-11367, Iran
3
Department of Physical Education and Special Motricity, Faculty of Physical Education and Mountain Sports, Transilvania University of Braşov, 500068 Braşov, Romania
4
Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Study of Bari, 70124 Bari, Italy
5
Department of Education and Sport Sciences, Pegaso Telematic University, 80143 Naples, Italy
*
Authors to whom correspondence should be addressed.
These authors share the last authorship.
Healthcare 2025, 13(15), 1938; https://doi.org/10.3390/healthcare13151938 (registering DOI)
Submission received: 11 July 2025 / Revised: 6 August 2025 / Accepted: 6 August 2025 / Published: 7 August 2025
(This article belongs to the Special Issue Exercise Biomechanics: Pathways to Improve Health)

Abstract

Background: This systematic review evaluates the efficacy of rehabilitation-focused exercise interventions for lumbar degenerative disc disease (DDD), a leading cause of chronic low back pain. Methods: Following PRISMA guidelines, a comprehensive search was conducted across international and regional databases (PubMed, Scopus, Web of Science, Magiran, SID, and Noormags) covering the period from January 2010 to January 2025. The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD420251088811. Using keywords such as “lumbar DDD,” “exercise therapy,” and “rehabilitation,” a total of 2495 records were identified. After screening, 20 studies—including clinical trials, quasi-experimental, and experimental designs—met the inclusion criteria and were assessed using the McMaster Critical Review Form for Quantitative Studies. Results: Interventions such as hydrotherapy, core stability training, Pilates, and suspension exercises were found to significantly reduce pain and improve functional outcomes. While multimodal approaches (e.g., aquatic exercise combined with acupuncture) showed positive effects, the comparative studies revealed no significant differences between modalities. Suspension training demonstrated superior efficacy in pain reduction compared to isolated core stability exercises. The methodological quality of included studies ranged from good to excellent, with the majority rated as very good or excellent (McMaster scores: 8 “excellent,” 7 “very good,” and 5 “good”). Common limitations among the studies included methodological heterogeneity, small sample sizes (n = 14–30), and insufficient long-term follow-up. Conclusions: Exercise-based rehabilitation is an effective strategy for managing lumbar DDD. Evidence particularly supports the use of suspension training and aquatic therapy for superior improvements in pain and functional outcomes. Future research should aim to adopt standardized protocols, recruit larger sample sizes, and include extended follow-up periods to produce more robust and generalizable findings.
Keywords: corrective exercises; lumbar DDD; therapeutic exercise; physical therapy corrective exercises; lumbar DDD; therapeutic exercise; physical therapy

Share and Cite

MDPI and ACS Style

Aali, S.; Rezazadeh, F.; Imani, F.; Sefidekhan, M.N.; Badicu, G.; Poli, L.; Fischetti, F.; Cataldi, S.; Greco, G. Effects of Exercise-Based Rehabilitation on Lumbar Degenerative Disc Disease: A Systematic Review. Healthcare 2025, 13, 1938. https://doi.org/10.3390/healthcare13151938

AMA Style

Aali S, Rezazadeh F, Imani F, Sefidekhan MN, Badicu G, Poli L, Fischetti F, Cataldi S, Greco G. Effects of Exercise-Based Rehabilitation on Lumbar Degenerative Disc Disease: A Systematic Review. Healthcare. 2025; 13(15):1938. https://doi.org/10.3390/healthcare13151938

Chicago/Turabian Style

Aali, Shirin, Farhad Rezazadeh, Fariborz Imani, Mahsa Nabati Sefidekhan, Georgian Badicu, Luca Poli, Francesco Fischetti, Stefania Cataldi, and Gianpiero Greco. 2025. "Effects of Exercise-Based Rehabilitation on Lumbar Degenerative Disc Disease: A Systematic Review" Healthcare 13, no. 15: 1938. https://doi.org/10.3390/healthcare13151938

APA Style

Aali, S., Rezazadeh, F., Imani, F., Sefidekhan, M. N., Badicu, G., Poli, L., Fischetti, F., Cataldi, S., & Greco, G. (2025). Effects of Exercise-Based Rehabilitation on Lumbar Degenerative Disc Disease: A Systematic Review. Healthcare, 13(15), 1938. https://doi.org/10.3390/healthcare13151938

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